| NPI | 1295738540 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | RUTH ELLEN ROBERTS Owner 770-207-9043 |
| Organization Subpart ? | No |
| Primary Taxonomy | 225400000X Rehabilitation Practitioner (Licence: GA 116745) |
| Enumeration Date | 2005-05-31 |
| Last Update Date | 2020-08-22 |