| NPI | 1073737391 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | STEVEN T. WILDER Clinic Director 770-761-2302 |
| Organization Subpart ? | No |
| Primary Taxonomy | 2255A2300X Specialist/Technologist, Athletic Trainer |
| Enumeration Date | 2007-04-11 |
| Last Update Date | 2020-08-22 |