| NPI | 1760411490 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | SUSAN H JOHNSON Director 770-995-2345 |
| Organization Subpart ? | No |
| Primary Taxonomy | 2251P0200X Physical Therapist, Pediatrics |
| Additional Taxonomies | 235Z00000X Speech-Language Pathologist, |
| 225XP0200X Occupational Therapist, Pediatrics | |
| Enumeration Date | 2006-07-03 |
| Last Update Date | 2020-08-22 |