| NPI | 1124220512 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | LEO DAVID PRIDGEN President 229-244-5314 |
| Organization Subpart ? | No |
| Primary Taxonomy | 111NR0400X Chiropractor, Rehabilitation (Licence: GA 1133) |
| Enumeration Date | 2007-06-05 |
| Last Update Date | 2020-08-22 |