| NPI | 1639568595 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | GREGG P BAUMGARTNER Responsible Party 770-365-9309 |
| Organization Subpart ? | No |
| Primary Taxonomy | 225100000X Physical Therapist (Licence: GA PT003457) |
| Enumeration Date | 2015-01-15 |
| Last Update Date | 2015-01-15 |