| NPI | 1063538924 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | LISA WELCH Direct Owner 404-289-1952 |
| Organization Subpart ? | No |
| Primary Taxonomy | 261QH0100X Clinic/Center, Health Services (Licence: GA 156445) |
| Enumeration Date | 2007-03-22 |
| Last Update Date | 2015-11-25 |