| NPI | 1083165294 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | MINSHENG WANG Owener 770-880-5788 |
| Organization Subpart ? | No |
| Primary Taxonomy | 261QP2300X Clinic/Center, Primary Care (Licence: GA 15063657) |
| Enumeration Date | 2016-10-23 |
| Last Update Date | 2017-03-30 |