| NPI | 1992251961 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | KIM H LARSEN Director Of Credentialing 770-874-5400 |
| Organization Subpart ? | No |
| Primary Taxonomy | 208100000X Physical Medicine & Rehabilitation |
| Enumeration Date | 2016-08-30 |
| Last Update Date | 2020-02-05 |