| NPI | 1255922621 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | ALIA ALLEN Credentialing Manager 912-754-0175 |
| Organization Subpart ? | No |
| Primary Taxonomy | 225100000X Physical Therapist |
| Additional Taxonomies | 225200000X Physical Therapy Assistant |
| Enumeration Date | 2021-01-28 |
| Last Update Date | 2021-02-03 |