Specialty |
Taxonomy Code | Specialty Code | Provider Type | |
Human Factors |
2251H1300X | 65 | Physical Therapist in Private Practice |
| NPI Number | 1780901330 |
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| LBN Legal business name | BRUNSWICK PHYSICAL THERAPY AND REHABILITATION LLC | ||||
| Authorized official | EDILBERTO ESTOMO - (PRESIDENT) | ||||
| Entity | Organization | ||||
| Organization subpart 1 | No | ||||
| Enumeration date | 04/22/2010 | ||||
| Last updated | 04/22/2010 - About 16 years ago | ||||
| Identifiers |
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