| NPI | 1164819405 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | ANAM RAFI Owner 678-773-8936 |
| Organization Subpart ? | No |
| Primary Taxonomy | 204C00000X Neuromusculoskeletal Medicine, Sports Medicine |
| Additional Taxonomies | 111N00000X Chiropractor |
| 164W00000X Licensed Practical Nurse | |
| Enumeration Date | 2015-04-24 |
| Last Update Date | 2015-04-24 |