NPI | 1972812808 |
---|---|
Entity Type | Organization |
Authorized Contact | JASON RANDALL STOOKSBURY Owner 865-257-8700 |
Organization Subpart ? | No |
Primary Taxonomy | 225100000X Physical Therapist (Licence: TN 7046) |
Enumeration Date | 2010-09-27 |
Last Update Date | 2010-09-27 |