| NPI | 1972834141 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | KELLEN JAMESON Managing Employee 678-981-3543 |
| Organization Subpart ? | No |
| Primary Taxonomy | 225100000X Physical Therapist |
| Additional Taxonomies | 225X00000X Occupational Therapist |
| Enumeration Date | 2010-01-27 |
| Last Update Date | 2019-09-26 |