| NPI | 1265760540 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | TROY BAGE Presedent 423-238-7217 |
| Organization Subpart ? | No |
| Primary Taxonomy | 261QP2000X Clinic/Center Physical Therapy (Licence: GA L200901087) |
| Additional Taxonomies | 261QM1300X Clinic/Center Multi-Specialty |
| 261QR0400X Clinic/Center Rehabilitation | |
| Enumeration Date | 2009-11-25 |
| Last Update Date | 2013-05-23 |