| NPI | 1558530121 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | JOHN P LANIER Owner 678-546-0550 |
| Organization Subpart ? | No |
| Primary Taxonomy | 208100000X Physical Medicine & Rehabilitation |
| Additional Taxonomies | 111NR0400X |
| 2081S0010X Physical Medicine & Rehabilitation, Sports Medicine | |
| Enumeration Date | 2008-02-27 |
| Last Update Date | 2008-02-27 |