| NPI | 1366800534 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | WILLIAM IVEY Organizer 404-823-8157 |
| Organization Subpart ? | No |
| Primary Taxonomy | 261QR0400X Clinic/Center, Rehabilitation (Licence: GA PT005195) |
| Enumeration Date | 2016-02-03 |
| Last Update Date | 2021-12-15 |