| NPI | 1417037946 |
|---|---|
| Doing Business As | PINE STREET PHYSICAL & OCCUPATIONAL THERAPY |
| Entity Type | Organization |
| Authorized Contact | JACK JONES Authorized Official 678-837-7176 |
| Organization Subpart ? | No |
| Primary Taxonomy | 261QP2000X Clinic/Center, Physical Therapy (Licence: CA 2403966) |
| Additional Taxonomies | 225X00000X Occupational Therapist |
| Enumeration Date | 2006-10-17 |
| Last Update Date | 2023-07-20 |