| NPI | 1023232204 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | CECILY KANNAPELL Clinical Nutritionist 770-532-5344 |
| Organization Subpart ? | No |
| Primary Taxonomy | 261QP0905X Clinic/Center Public Health, State or Local (Licence: GA LD001436) |
| Enumeration Date | 2007-04-12 |
| Last Update Date | 2020-08-22 |