| NPI | 1851748172 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | LISA STEPHENS Authorized Official 706-350-1338 |
| Organization Subpart ? | No |
| Primary Taxonomy | 225100000X Physical Therapist (Licence: GA 6464) |
| Enumeration Date | 2016-05-17 |
| Last Update Date | 2017-09-06 |