| NPI | 1982168464 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | CHANDA HINTON Executive Director 800-766-4255 |
| Organization Subpart ? | No |
| Primary Taxonomy | 261QR0400X Clinic/Center, Rehabilitation |
| Additional Taxonomies | 225100000X Physical Therapist |
| Enumeration Date | 2019-01-29 |
| Last Update Date | 2025-06-25 |