| NPI | 1972862761 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | BRICE JACKSON Owner/Clinical Director 540-400-8505 |
| Organization Subpart ? | No |
| Primary Taxonomy | 225X00000X Occupational Therapist (Licence: VA 0119004835) |
| Enumeration Date | 2012-05-14 |
| Last Update Date | 2022-03-23 |