| NPI | 1962958462 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | CARLA OWENS Co Owner 240-305-2352 |
| Organization Subpart ? | No |
| Primary Taxonomy | 261QP2000X Clinic/Center Physical Therapy (Licence: GA PT008440) |
| Additional Taxonomies | 261QP2000X Clinic/Center Physical Therapy (Licence: GA PT011362) |
| Enumeration Date | 2016-08-25 |
| Last Update Date | 2016-08-25 |