| NPI | 1891280921 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | JAMIE NEDDERMAN Office Manager 770-710-2390 |
| Organization Subpart ? | No |
| Primary Taxonomy | 235Z00000X Speech-Language Pathologist, (Licence: GA SLP005649) |
| Additional Taxonomies | 225100000X Physical Therapist (Licence: GA PT009627) |
| Enumeration Date | 2018-07-01 |
| Last Update Date | 2018-07-01 |