| NPI | 1578152351 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | RA'KESHIA BROGDON Credentialing Specialist 404-941-1233 |
| Organization Subpart ? | No |
| Primary Taxonomy | 208100000X Physical Medicine & Rehabilitation |
| Enumeration Date | 2021-01-15 |
| Last Update Date | 2022-01-03 |