| NPI | 1972036978 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | CYNTHIA GOODMAN CEO/President 6785-588-6767 |
| Organization Subpart ? | No |
| Primary Taxonomy | 261QH0100X Clinic/Center, Health Services (Licence: GA 48419) |
| Additional Taxonomies | 261QM2500X Clinic/Center, Medical Specialty (Licence: GA 48419) |
| 261QP2000X Clinic/Center, Physical Therapy (Licence: GA 48419) | |
| 261QR1100X Clinic/Center, Research (Licence: GA 48419) | |
| Enumeration Date | 2017-04-06 |
| Last Update Date | 2017-04-06 |