| NPI | 1588667430 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | BRIAN L WEST Administrator 912-658-1234 |
| Organization Subpart ? | No |
| Primary Taxonomy | 261QR0400X Clinic/Center Rehabilitation |
| Additional Taxonomies | 225100000X Physical Therapist |
| 225X00000X Occupational Therapist | |
| 235Z00000X Speech-Language Pathologist | |
| 332B00000X Durable Medical Equipment & Medical Supplies | |
| Enumeration Date | 2005-05-24 |
| Last Update Date | 2022-11-29 |