| NPI | 1982691176 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | RICHARD A JOHANSEN President 352-372-8970 |
| Organization Subpart ? | No |
| Primary Taxonomy | 225100000X Physical Therapist (Licence: FL PT5622) |
| Enumeration Date | 2005-10-03 |
| Last Update Date | 2008-04-02 |