| NPI | 1073680070 |
|---|---|
| Doing Business As | REHABILITATION MEDICINE |
| Entity Type | Organization |
| Authorized Contact | ROBIN J. MADDOX Provider Enrollment Coordinator 912-350-9335 |
| Organization Subpart ? | No |
| Primary Taxonomy | 208100000X Physical Medicine & Rehabilitation |
| Additional Taxonomies | 363L00000X Nurse Practitioner |
| 207X00000X Orthopaedic Surgery | |
| Enumeration Date | 2006-11-29 |
| Last Update Date | 2012-05-01 |