| NPI | 1639785553 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | THOMAS HAWK Authorized Officail 706-564-7796 |
| Organization Subpart ? | No |
| Primary Taxonomy | 225100000X Physical Therapist |
| Additional Taxonomies | 225X00000X Occupational Therapist |
| Enumeration Date | 2020-09-16 |
| Last Update Date | 2020-11-09 |