NPI | 1982799516 |
---|---|
Entity Type | Organization |
Authorized Contact | KEVIN TROY BOUTIN President 662-231-7304 |
Organization Subpart ? | No |
Primary Taxonomy | 225100000X Physical Therapist |
Additional Taxonomies | 225X00000X Occupational Therapist |
235Z00000X Speech-Language Pathologist, | |
Enumeration Date | 2006-10-03 |
Last Update Date | 2016-09-27 |