| NPI | 1669785580 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | THEA E. JACK Owner/Physical Therapist 912-713-0277 |
| Organization Subpart ? | No |
| Primary Taxonomy | 2251P0200X Physical Therapist, Pediatrics (Licence: GA PT 009479) |
| Additional Taxonomies | 225X00000X Occupational Therapist (Licence: GA OT004895) |
| 225XP0200X Occupational Therapist, Pediatrics (Licence: GA OT002973) | |
| Enumeration Date | 2010-07-20 |
| Last Update Date | 2020-07-31 |