| NPI | 1952814188 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | REGINA FRAZIER Owner 762-685-6366 |
| Organization Subpart ? | No |
| Primary Taxonomy | 261QP2000X Clinic/Center, Physical Therapy (Licence: GA OT004985) |
| Enumeration Date | 2017-11-09 |
| Last Update Date | 2017-11-09 |