| NPI | 1073274288 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | ANGELA GRANT Owner 678-699-6978 |
| Organization Subpart ? | Yes |
| Primary Taxonomy | 261QH0100X Clinic/Center, Health Services |
| Additional Taxonomies | 291U00000X Clinical Medical Laboratory |
| Enumeration Date | 2022-01-10 |
| Last Update Date | 2022-02-20 |