| NPI | 1770801037 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | JASON A REGIS Owner 678-665-0455 |
| Organization Subpart ? | No |
| Primary Taxonomy | 111N00000X Chiropractor (Licence: GA 008364) |
| Additional Taxonomies | 225100000X Physical Therapist |
| Enumeration Date | 2010-05-12 |
| Last Update Date | 2013-09-06 |