| NPI | 1992209878 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | MADISON ELIZABETH GRAY JENSEN Physical Therapist/Owner 636-795-9502 |
| Organization Subpart ? | No |
| Primary Taxonomy | 261QP2000X Clinic/Center, Physical Therapy (Licence: NV 3436) |
| Enumeration Date | 2018-03-23 |
| Last Update Date | 2018-03-23 |