| NPI | 1073116554 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | KRISTYN MANZI Owner 770-683-4495 |
| Organization Subpart ? | No |
| Primary Taxonomy | 261QM1300X Clinic/Center, Multi-Specialty |
| Additional Taxonomies | 261QM2500X Clinic/Center, Medical Specialty |
| Enumeration Date | 2020-11-18 |
| Last Update Date | 2020-11-23 |