| NPI | 1700436987 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | TERESA BRISTOL CEO 470-733-2135 |
| Organization Subpart ? | No |
| Primary Taxonomy | 225100000X Physical Therapist |
| Additional Taxonomies | 2251P0200X Physical Therapist, Pediatrics |
| 2251S0007X Physical Therapist, Sports | |
| 2251X0800X Physical Therapist, Orthopedic | |
| Enumeration Date | 2019-09-19 |
| Last Update Date | 2019-09-19 |