# ENHANCED PHYSICAL MEDICINE

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- **Entity:** Organization
- **Status:** Active
- **Organization subpart:** No

## Provider details

- **NPI number:** 1740695279
- **Authorized official:** DR. MATTHEW EISEN DC (OWNER)
- **Authorized official phone:** (770) 552-7500

## Contact information

- **Practice address:** 622 W CROSSVILLE RD, 100, ROSWELL, GA 30075-2560
- **Practice address phone:** (770) 552-7500
- **Practice address fax:** (888) 819-9318
- **Mailing address:** 622 W CROSSVILLE RD, SUITE \#100, ROSWELL, GA 30075-2560
- **Mailing address phone:** (770) 552-7500
- **Mailing address fax:** (888) 819-9318

## Taxonomy

| Code | Description | License number | State | Primary |
| --- | --- | --- | --- | --- |
| 208100000X | Physical Medicine & Rehabilitation Physician | CHIR007877 | GA | Yes |

## Other

- **Enumeration date:** 06/23/2014
- **Last updated:** 06/23/2014