| NPI | 1518180645 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | DANIEL LYNN MIDDLETON Billing Manager 770-850-0857 |
| Organization Subpart ? | No |
| Primary Taxonomy | 225100000X Physical Therapist (Licence: GA PT007889) |
| Enumeration Date | 2007-04-10 |
| Last Update Date | 2020-08-22 |