| NPI | 1760095202 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | GENE DOUGLAS MCFADDEN Co Owner 404-624-6151 |
| Organization Subpart ? | No |
| Primary Taxonomy | 2255A2300X Specialist/Technologist, Athletic Trainer |
| Enumeration Date | 2020-08-25 |
| Last Update Date | 2020-08-25 |