| NPI | 1972100444 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | KENNESHIA M MARTIN Owner 813-564-5468 |
| Organization Subpart ? | No |
| Primary Taxonomy | 225100000X Physical Therapist |
| Additional Taxonomies | 163W00000X Registered Nurse |
| 225X00000X Occupational Therapist | |
| 235Z00000X Speech-Language Pathologist, | |
| Enumeration Date | 2020-10-07 |
| Last Update Date | 2020-10-07 |