| NPI | 1982994281 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | KEVIN N GROOM Owner 850-433-1656 |
| Organization Subpart ? | No |
| Primary Taxonomy | 225X00000X Occupational Therapist |
| Additional Taxonomies | 225100000X Physical Therapist |
| Enumeration Date | 2011-04-08 |
| Last Update Date | 2020-06-08 |