NPI | 1174956924 |
---|---|
Entity Type | Organization |
Authorized Contact | BRITTANY JENNINGS Owner 678-386-4395 |
Organization Subpart ? | No |
Primary Taxonomy | 225100000X Physical Therapist (Licence: GA PT009158) |
Additional Taxonomies | 225X00000X Occupational Therapist (Licence: GA OT004893) |
235Z00000X Speech-Language Pathologist, (Licence: GA SLP006507) | |
Enumeration Date | 2013-08-15 |
Last Update Date | 2013-08-15 |