| NPI | 1366812331 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | ANNA GAYLORD Credentialing Manager 678-837-7176 |
| Organization Subpart ? | No |
| Primary Taxonomy | 261QP2000X Clinic/Center, Physical Therapy (Licence: MD 22199) |
| Enumeration Date | 2015-10-02 |
| Last Update Date | 2026-01-07 |