| NPI | 1487951034 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | BRIAN EDWARD OUELLETTE Managing Member 678-297-0901 |
| Organization Subpart ? | No |
| Primary Taxonomy | 208100000X Physical Medicine & Rehabilitation (Licence: GA 038955) |
| Enumeration Date | 2011-02-17 |
| Last Update Date | 2011-10-06 |