| NPI | 1821817503 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | YUGANDHAR KANDIMALLA President 678-982-3590 |
| Organization Subpart ? | No |
| Primary Taxonomy | 207Q00000X Family Medicine |
| Additional Taxonomies | 207R00000X Internal Medicine |
| 225100000X Physical Therapist | |
| 225X00000X Occupational Therapist | |
| 235Z00000X Speech-Language Pathologist, | |
| Enumeration Date | 2024-10-09 |
| Last Update Date | 2024-11-20 |