| NPI | 1073786984 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | TAMERA FIRNBACH Owner 770-425-6068 |
| Organization Subpart ? | No |
| Primary Taxonomy | 305R00000X Preferred Provider Organization (Licence: GA CHIR0006878) |
| Enumeration Date | 2008-04-11 |
| Last Update Date | 2008-04-11 |