| NPI | 1154454122 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | BRANTON RICE QUEEN Owner 678-364-9412 |
| Organization Subpart ? | No |
| Primary Taxonomy | 261QP2000X Clinic/Center, Physical Therapy |
| Additional Taxonomies | 225100000X Physical Therapist |
| 225X00000X Occupational Therapist | |
| Enumeration Date | 2007-03-13 |
| Last Update Date | 2010-06-22 |