| NPI | 1972132603 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | STEPHANIE BINGHAM Member 501-339-8282 |
| Organization Subpart ? | No |
| Primary Taxonomy | 225100000X Physical Therapist |
| Additional Taxonomies | 225X00000X Occupational Therapist |
| Enumeration Date | 2020-04-04 |
| Last Update Date | 2020-07-29 |