| NPI | 1265750871 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | ANNA GAYLORD Credentialing Manager 678-837-7176 |
| Organization Subpart ? | No |
| Primary Taxonomy | 261QP2000X Clinic/Center, Physical Therapy (Licence: NJ 40QA00255900) |
| Additional Taxonomies | 225X00000X Occupational Therapist |
| 225100000X Physical Therapist | |
| Enumeration Date | 2010-05-06 |
| Last Update Date | 2026-01-07 |