| NPI | 1831624527 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | KELLEN JAMESON CFO 678-932-3629 |
| Organization Subpart ? | No |
| Primary Taxonomy | 225100000X Physical Therapist |
| Additional Taxonomies | 225X00000X Occupational Therapist |
| Enumeration Date | 2017-05-01 |
| Last Update Date | 2019-05-03 |