| NPI | 1003948795 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | AMANDA GRACE FROMKIN Director Of Credentialing 706-494-3071 |
| Organization Subpart ? | Yes |
| Primary Taxonomy | 261QP2000X Clinic/Center, Physical Therapy |
| Additional Taxonomies | 332B00000X Durable Medical Equipment & Medical Supplies |
| 207X00000X Orthopaedic Surgery | |
| Enumeration Date | 2007-03-09 |
| Last Update Date | 2018-10-24 |