| NPI | 1962968115 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | AMBER FORDHAM COO 833-418-6824 |
| Organization Subpart ? | No |
| Primary Taxonomy | 163W00000X Registered Nurse |
| Additional Taxonomies | 225100000X Physical Therapist |
| Enumeration Date | 2019-02-13 |
| Last Update Date | 2019-10-23 |