| NPI | 1851719868 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | GWEN SPARKMAN Owner 706-897-5489 |
| Organization Subpart ? | No |
| Primary Taxonomy | 261QR0400X Clinic/Center, Rehabilitation (Licence: GA SLP007736) |
| Enumeration Date | 2014-04-07 |
| Last Update Date | 2014-04-18 |