| NPI | 1992402770 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | BEVERLY IVETTE REYES Physical Therapist 904-458-7655 |
| Organization Subpart ? | No |
| Primary Taxonomy | 2251P0200X Physical Therapist, Pediatrics |
| Enumeration Date | 2023-02-13 |
| Last Update Date | 2024-08-07 |