| NPI | 1962636050 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | WESLEY JAMES JOHNSON President 9288-545-5555 |
| Organization Subpart ? | No |
| Primary Taxonomy | 225100000X Physical Therapist (Licence: AZ 2641) |
| Additional Taxonomies | 225100000X Physical Therapist (Licence: AZ 8192) |
| 225100000X Physical Therapist (Licence: AZ 6762) | |
| Enumeration Date | 2009-05-05 |
| Last Update Date | 2009-05-05 |