| NPI | 1790806008 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | TEDDI R ERICKSON Office Manager 770-973-3466 |
| Organization Subpart ? | No |
| Primary Taxonomy | 224Z00000X Occupational Therapy Assistant (Licence: GA 19703) |
| Additional Taxonomies | 225100000X Physical Therapist (Licence: GA 19703) |
| 225200000X Physical Therapy Assistant (Licence: GA 19703) | |
| 225X00000X Occupational Therapist (Licence: GA 19703) | |
| 235Z00000X Speech-Language Pathologist, (Licence: GA 19703) | |
| Enumeration Date | 2007-04-03 |
| Last Update Date | 2020-08-22 |