| NPI | 1477909364 |
|---|---|
| Doing Business As | OPTIM THERAPY - VIDALIA |
| Entity Type | Organization |
| Authorized Contact | TERRY L CRAIG Provider Enrollment Coordinator 912-644-5346 |
| Organization Subpart ? | Yes |
| Primary Taxonomy | 261QR0400X Clinic/Center, Rehabilitation |
| Additional Taxonomies | 225100000X Physical Therapist |
| 225X00000X Occupational Therapist | |
| Enumeration Date | 2016-05-10 |
| Last Update Date | 2019-09-27 |