| NPI | 1962468827 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | SHANI T JOHNSON Owner 715-723-4451 |
| Organization Subpart ? | No |
| Primary Taxonomy | 261QP2000X Clinic/Center, Physical Therapy (Licence: WI 261QP2000X) |
| Enumeration Date | 2006-04-20 |
| Last Update Date | 2015-07-22 |