Organization
KNOCKOUTBODYFITTNESS
Active
Organization subpart
No
Provider details
NPI number
Authorized official
KEISHA OLIVER (CEO)
(678) 637-8318
Entity
Organization
Contact information
Practice address
791 MARION AVE SE, ATLANTA, GA 30312-3615
(678) 637-8318
Mailing address
791 MARION AVE SE, ATLANTA, GA 30312-3615
Taxonomy
Speciality
Code
Description
License number
State
225X00000X
Occupational Therapist
Primary
—
—
Other
Enumeration date
04/01/2016
Last updated
04/01/2016
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