| NPI | 1225704802 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | LARRY JAMES RUTLAND Owner 678-761-2863 |
| Organization Subpart ? | No |
| Primary Taxonomy | 208000000X Pediatrics |
| Additional Taxonomies | 225XP0200X Occupational Therapist, Pediatrics |
| 261QH0700X Clinic/Center, Hearing and Speech | |
| 261QP2000X Clinic/Center, Physical Therapy | |
| Enumeration Date | 2021-08-23 |
| Last Update Date | 2022-10-12 |