| NPI | 1396495206 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | ALEX JUTIS Owner 678-730-6240 |
| Organization Subpart ? | No |
| Primary Taxonomy | 207R00000X Internal Medicine |
| Additional Taxonomies | 261QP2000X Clinic/Center Physical Therapy |
| Enumeration Date | 2022-03-24 |
| Last Update Date | 2022-03-24 |