| NPI | 1912409046 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | STANLEY TROYD LEGRAND Occupational Therapist 267-549-2966 |
| Organization Subpart ? | No |
| Primary Taxonomy | 261QP2000X Clinic/Center, Physical Therapy (Licence: GA OT004199) |
| Additional Taxonomies | 261QP2000X Clinic/Center, Physical Therapy |
| Enumeration Date | 2018-03-05 |
| Last Update Date | 2020-07-28 |