| NPI | 1720373020 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | LISA L. STACY CEO 678-472-4042 |
| Organization Subpart ? | No |
| Primary Taxonomy | 225100000X Physical Therapist (Licence: GA GA007304) |
| Additional Taxonomies | 225X00000X Occupational Therapist |
| Enumeration Date | 2011-06-14 |
| Last Update Date | 2024-11-15 |