| NPI | 1962727230 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | TAMARA HARRIS LOGAN Employee 941-927-1123 |
| Organization Subpart ? | No |
| Primary Taxonomy | 208100000X Physical Medicine & Rehabilitation (Licence: FL me101995) |
| Additional Taxonomies | 332B00000X Durable Medical Equipment & Medical Supplies |
| Enumeration Date | 2010-03-30 |
| Last Update Date | 2023-12-07 |