| NPI | 1013809482 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | JOHN SIMUEL BEASLEY Owner/Nurse Practitioner 404-749-0571 |
| Organization Subpart ? | No |
| Primary Taxonomy | 261QH0100X Clinic/Center Health Service |
| Additional Taxonomies | 363L00000X Nurse Practitioner |
| Enumeration Date | 2025-07-18 |
| Last Update Date | 2025-08-14 |