| NPI | 1801368675 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | NORMANIE MCKENZIE RICKS Owner 678-386-3172 |
| Organization Subpart ? | No |
| Primary Taxonomy | 225X00000X Occupational Therapist |
| Additional Taxonomies | 261QR0400X Clinic/Center, Rehabilitation |
| Enumeration Date | 2018-12-18 |
| Last Update Date | 2019-07-17 |