| NPI | 1043684392 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | ANTONIO VASHAWN PRUITT Owner/ CEO 205-705-4189 |
| Organization Subpart ? | No |
| Primary Taxonomy | 225100000X Physical Therapist (Licence: GA PT011344) |
| Enumeration Date | 2015-11-24 |
| Last Update Date | 2015-11-24 |