| NPI | 1245842392 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | NICKY S SHAH Owner 706-615-7539 |
| Organization Subpart ? | No |
| Primary Taxonomy | 261QP2000X Clinic/Center, Physical Therapy |
| Additional Taxonomies | 225100000X Physical Therapist |
| Enumeration Date | 2020-08-20 |
| Last Update Date | 2020-08-22 |