| NPI | 1023362191 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | SCOTT DEPOL Member/Manager 678-880-6118 |
| Organization Subpart ? | No |
| Primary Taxonomy | 207Q00000X Family Medicine (Licence: GA 26936) |
| Additional Taxonomies | 111N00000X Chiropractor (Licence: GA CHIRO07708) |
| Enumeration Date | 2012-10-29 |
| Last Update Date | 2012-10-29 |