| NPI | 1063961043 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | ROBIN S REICH Owner 770-992-3353 |
| Organization Subpart ? | No |
| Primary Taxonomy | 305R00000X Preferred Provider Organization (Licence: GA DN10035) |
| Enumeration Date | 2016-10-01 |
| Last Update Date | 2016-10-01 |