| NPI | 1992766315 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | TOMMY DIRE MATHENA President 434-836-4158 |
| Organization Subpart ? | No |
| Primary Taxonomy | 225100000X Physical Therapist (Licence: VA 23005523) |
| Additional Taxonomies | 225100000X Physical Therapist (Licence: VA 2305005523) |
| 225X00000X Occupational Therapist | |
| Enumeration Date | 2006-03-28 |
| Last Update Date | 2012-01-25 |