| NPI | 1972635175 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | WESLEY BURTON MCDANIEL Owner 770-442-0836 |
| Organization Subpart ? | No |
| Primary Taxonomy | 225400000X Rehabilitation Practitioner (Licence: GA 026588) |
| Enumeration Date | 2007-03-12 |
| Last Update Date | 2008-03-20 |