| NPI | 1861513210 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | DANIEL LYNN MIDDLETON Billing Manager 770-850-0857 |
| Organization Subpart ? | No |
| Primary Taxonomy | 261QP2000X Clinic/Center, Physical Therapy |
| Enumeration Date | 2007-04-03 |
| Last Update Date | 2020-08-22 |