| NPI | 1609207885 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | RICHARD J MCKIBBEN Owner 706-325-6971 |
| Organization Subpart ? | No |
| Primary Taxonomy | 2251E1300X Physical Therapist, Electrophysiology, Clinical (Licence: GA PT008390) |
| Additional Taxonomies | 225100000X Physical Therapist |
| 2251S0007X Physical Therapist, Sports | |
| 2251X0800X Physical Therapist, Orthopedic (Licence: GA PT008390) | |
| Enumeration Date | 2013-12-12 |
| Last Update Date | 2025-05-19 |