| NPI | 1134386337 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | JEFF WENTZ Business Manager 770-517-2480 |
| Organization Subpart ? | No |
| Primary Taxonomy | 2251P0200X Physical Therapist, Pediatrics |
| Additional Taxonomies | 225100000X Physical Therapist |
| 225X00000X Occupational Therapist | |
| 225XP0200X Occupational Therapist, Pediatrics | |
| Enumeration Date | 2008-05-16 |
| Last Update Date | 2008-05-16 |