| NPI | 1205575677 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | KEVIN KAMPLEY Owner 770-800-8010 |
| Organization Subpart ? | No |
| Primary Taxonomy | 261QP2000X Clinic/Center, Physical Therapy |
| Additional Taxonomies | 261QM1300X Clinic/Center, Multi-Specialty |
| Enumeration Date | 2022-06-02 |
| Last Update Date | 2022-06-02 |