| NPI | 1043054299 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | MARILYNE L JONES Manager 678-382-7470 |
| Organization Subpart ? | No |
| Primary Taxonomy | 363L00000X Nurse Practitioner |
| Additional Taxonomies | 246RP1900X Technician, Pathology, Phlebotomy |
| Enumeration Date | 2024-06-22 |
| Last Update Date | 2024-06-22 |