| NPI | 1992997563 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | AMIE ALAGOOD LOCICERO Co Owner 678-377-2833 |
| Organization Subpart ? | No |
| Primary Taxonomy | 2251P0200X Physical Therapist, Pediatrics |
| Additional Taxonomies | 225XP0200X Occupational Therapist, Pediatrics |
| Enumeration Date | 2007-08-16 |
| Last Update Date | 2010-09-23 |