| NPI | 1891293593 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | WANDA SWAN Owner 912-659-8099 |
| Organization Subpart ? | No |
| Primary Taxonomy | 2251P0200X Physical Therapist, Pediatrics (Licence: GA GA006299) |
| Enumeration Date | 2018-01-28 |
| Last Update Date | 2022-04-03 |