| NPI | 1639843238 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | JOYCE TERRELL Owner 678-471-4615 |
| Organization Subpart ? | No |
| Primary Taxonomy | 261QP2000X Clinic/Center, Physical Therapy |
| Additional Taxonomies | 2255A2300X Specialist/Technologist, Athletic Trainer |
| 261QM1300X Clinic/Center, Multi-Specialty | |
| Enumeration Date | 2021-08-06 |
| Last Update Date | 2022-05-23 |