| NPI | 1043225758 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | VICKY B CARROLL Director Of Operations 678-735-3201 |
| Organization Subpart ? | No |
| Primary Taxonomy | 261Q00000X Clinic/Center (Licence: GA BL04-03274) |
| Enumeration Date | 2006-07-30 |
| Last Update Date | 2010-01-05 |