| NPI | 1669529905 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | MALYNDA COPELAND Operations Manager 770-442-0727 |
| Organization Subpart ? | No |
| Primary Taxonomy | 225100000X Physical Therapist |
| Additional Taxonomies | 2081S0010X Physical Medicine & Rehabilitation, Sports Medicine |
| Enumeration Date | 2007-01-05 |
| Last Update Date | 2022-04-08 |