| NPI | 1205375896 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | DEREK S SCOTT Owner 678-552-6294 |
| Organization Subpart ? | No |
| Primary Taxonomy | 208100000X Physical Medicine & Rehabilitation (Licence: GA 077308) |
| Enumeration Date | 2017-02-16 |
| Last Update Date | 2021-06-10 |