| NPI | 1356527642 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | RICHARD LEO SHORTT Owner 770-749-8701 |
| Organization Subpart ? | No |
| Primary Taxonomy | 111NS0005X Chiropractor, Sports Physician (Licence: GA CHIRO07794) |
| Enumeration Date | 2008-01-16 |
| Last Update Date | 2008-01-16 |