| NPI | 1629651096 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | RA'KESHIA BROGDON Credentialing Specialist 404-941-1233 |
| Organization Subpart ? | No |
| Primary Taxonomy | 208100000X Physical Medicine & Rehabilitation |
| Enumeration Date | 2021-05-03 |
| Last Update Date | 2023-06-01 |