| NPI | 1609445311 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | CARMEN PHILPOT Director Rev 678-403-3568 |
| Organization Subpart ? | No |
| Primary Taxonomy | 225100000X Physical Therapist |
| Additional Taxonomies | 225X00000X Occupational Therapist |
| Enumeration Date | 2021-06-18 |
| Last Update Date | 2021-06-18 |