| NPI | 1699141218 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | MARY LEACH Billing 678-736-6342 |
| Organization Subpart ? | No |
| Primary Taxonomy | 208100000X Physical Medicine & Rehabilitation |
| Additional Taxonomies | 111N00000X Chiropractor |
| Enumeration Date | 2015-08-18 |
| Last Update Date | 2015-08-20 |