| NPI | 1982685814 |
|---|---|
| Former Legal Business Name | WEITLAUF & VANCE PSC |
| Entity Type | Organization |
| Authorized Contact | MARK S VANCE President 270-442-4396 |
| Organization Subpart ? | No |
| Primary Taxonomy | 261QP2000X Clinic/Center, Physical Therapy |
| Enumeration Date | 2005-11-08 |
| Last Update Date | 2008-09-17 |