| NPI | 1619533114 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | ABDUL WANYE HAWKINS Physical Fitness Trainer 678-788-3646 |
| Organization Subpart ? | No |
| Primary Taxonomy | 251S00000X Community/Behavioral Health |
| Enumeration Date | 2019-05-10 |
| Last Update Date | 2019-05-10 |