| NPI | 1083659783 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | ANNA GAYLORD Credentialing Manager 678-837-7176 |
| Organization Subpart ? | No |
| Primary Taxonomy | 261QP2000X Clinic/Center, Physical Therapy |
| Additional Taxonomies | 208100000X Physical Medicine & Rehabilitation |
| Enumeration Date | 2006-06-17 |
| Last Update Date | 2026-01-07 |