| NPI | 1912188962 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | CHRISTOPHER JAMES MALLARE Clinical Director 770-932-3212 |
| Organization Subpart ? | No |
| Primary Taxonomy | 225100000X Physical Therapist (Licence: GA 4122) |
| Enumeration Date | 2007-11-19 |
| Last Update Date | 2007-11-19 |