| NPI | 1316117740 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | GUILLERMO AVILES President 678-234-0675 |
| Organization Subpart ? | No |
| Primary Taxonomy | 208D00000X General Practice |
| Additional Taxonomies | 225100000X Physical Therapist |
| Enumeration Date | 2008-02-29 |
| Last Update Date | 2008-06-09 |