| NPI | 1700134913 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | BRIAN OUELLETTE Owner 770-312-5005 |
| Organization Subpart ? | No |
| Primary Taxonomy | 208100000X Physical Medicine & Rehabilitation (Licence: GA 038955) |
| Enumeration Date | 2012-08-17 |
| Last Update Date | 2012-08-17 |