| NPI | 1104415983 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | BRIAN MCCLUSKEY CEO/Member 706-322-7762 |
| Organization Subpart ? | No |
| Primary Taxonomy | 225100000X Physical Therapist |
| Additional Taxonomies | 2251E1300X Physical Therapist, Electrophysiology, Clinical |
| 225X00000X Occupational Therapist | |
| 235Z00000X Speech-Language Pathologist, | |
| 261QP2000X Clinic/Center, Physical Therapy | |
| Enumeration Date | 2021-01-15 |
| Last Update Date | 2021-09-13 |