| NPI | 1316200579 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | OTIS L BONNER Atto RN Ey 770-485-1329 |
| Organization Subpart ? | No |
| Primary Taxonomy | 208100000X Physical Medicine & Rehabilitation |
| Additional Taxonomies | 363L00000X Nurse Practitioner |
| 225100000X Physical Therapist | |
| Enumeration Date | 2012-06-21 |
| Last Update Date | 2012-06-21 |