| NPI | 1225417371 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | MICHAEL FELISILDA Physical Therapist 706-897-5835 |
| Organization Subpart ? | No |
| Primary Taxonomy | 225100000X Physical Therapist (Licence: MD 23559) |
| Additional Taxonomies | 225X00000X Occupational Therapist (Licence: MD 05279) |
| Enumeration Date | 2015-05-21 |
| Last Update Date | 2016-01-06 |