| NPI | 1023787710 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | LUCY THOMAS Billing Manager 678-428-7812 |
| Organization Subpart ? | No |
| Primary Taxonomy | 111N00000X Chiropractor |
| Additional Taxonomies | 225100000X Physical Therapist |
| 225200000X Physical Therapy Assistant | |
| Enumeration Date | 2021-09-07 |
| Last Update Date | 2021-09-07 |