| NPI | 1487073904 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | AMY WALLACE CEO/Owner 678-780-6941 |
| Organization Subpart ? | No |
| Primary Taxonomy | 261QP2000X Clinic/Center, Physical Therapy (Licence: GA GA OT 004063) |
| Enumeration Date | 2014-04-11 |
| Last Update Date | 2014-04-11 |