| NPI | 1942560719 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | JENNIFER POLLOCK SHANKLE Owner 678-373-7333 |
| Organization Subpart ? | No |
| Primary Taxonomy | 225100000X Physical Therapist (Licence: GA PT002826) |
| Enumeration Date | 2012-05-25 |
| Last Update Date | 2012-05-25 |