| NPI | 1063751402 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | OVID STEPHEN BARROW Medical Director 770-559-3642 |
| Organization Subpart ? | No |
| Primary Taxonomy | 207RA0000X Internal Medicine Adolescent Medicine (Licence: GA 061203) |
| Enumeration Date | 2013-02-05 |
| Last Update Date | 2013-02-05 |