| NPI | 1124115340 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | JANICE DK ILORI Physical Therapist 678-432-2044 |
| Organization Subpart ? | No |
| Primary Taxonomy | 225100000X Physical Therapist (Licence: GA PT006197) |
| Enumeration Date | 2006-10-08 |
| Last Update Date | 2020-08-22 |