| NPI | 1003554726 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | LASHAUN ELLIOTT Owner 678-819-7777 |
| Organization Subpart ? | No |
| Primary Taxonomy | 2083X0100X Preventive Medicine, Occupational Medicine |
| Additional Taxonomies | 2083A0300X Preventive Medicine, Addiction Medicine |
| 208VP0000X | |
| 261QP2300X Clinic/Center, Primary Care | |
| 261QP3300X Clinic/Center, Pain | |
| Enumeration Date | 2022-05-23 |
| Last Update Date | 2025-02-04 |