| NPI | 1982155123 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | IAN OPPEL COO 980-254-7007 |
| Organization Subpart ? | No |
| Primary Taxonomy | 261QR0400X Clinic/Center, Rehabilitation |
| Additional Taxonomies | 261Q00000X Clinic/Center |
| Enumeration Date | 2016-10-24 |
| Last Update Date | 2025-04-03 |