| NPI | 1992297428 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | JARED G ERDMIER Owner 779-423-2044 |
| Organization Subpart ? | No |
| Primary Taxonomy | 208D00000X General Practice |
| Additional Taxonomies | 208100000X Physical Medicine & Rehabilitation |
| Enumeration Date | 2018-05-31 |
| Last Update Date | 2020-03-31 |