| NPI | 1083884803 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | REITA KING Part Owner 678-303-3200 |
| Organization Subpart ? | No |
| Primary Taxonomy | 207PE0005X Emergency Medicine, Undersea and Hyperbaric Medicine (Licence: GA 31517) |
| Additional Taxonomies | 225400000X Rehabilitation Practitioner (Licence: GA GA021872) |
| 208100000X Physical Medicine & Rehabilitation (Licence: GA 021872) | |
| Enumeration Date | 2008-03-07 |
| Last Update Date | 2014-06-10 |