| NPI | 1952877615 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | WHITNEY GLOVER Credentialing 678-783-7615 |
| Organization Subpart ? | No |
| Primary Taxonomy | 208100000X Physical Medicine & Rehabilitation |
| Additional Taxonomies | 207X00000X Orthopaedic Surgery |
| Enumeration Date | 2018-10-22 |
| Last Update Date | 2023-02-16 |