| NPI | 1053598284 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | PATRICIA P FERGUSON Agent 404-559-5190 |
| Organization Subpart ? | No |
| Primary Taxonomy | 261QP2300X Clinic/Center, Primary Care (Licence: GA 025399) |
| Additional Taxonomies | 261QA0006X Clinic/Center, Ambulatory Fertility Facility (Licence: GA 25399) |
| 261QF0050X Clinic/Center, Family Planning, Non-Surgical (Licence: GA 25399) | |
| 261QH0100X Clinic/Center, Health Services (Licence: GA 25399) | |
| 261QP3300X Clinic/Center, Pain (Licence: GA 25399) | |
| 261QU0200X Clinic/Center, Urgent Care (Licence: GA 25399) | |
| Enumeration Date | 2008-01-30 |
| Last Update Date | 2012-08-29 |