| NPI | 1215963483 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | RONALD OWEN MCDEARIS Practice Manager 706-722-7239 |
| Organization Subpart ? | No |
| Primary Taxonomy | 208100000X Physical Medicine & Rehabilitation |
| Enumeration Date | 2006-06-22 |
| Last Update Date | 2020-08-22 |