| NPI | 1083379366 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | STEPHEN MOSLEY President 770-757-2190 |
| Organization Subpart ? | No |
| Primary Taxonomy | 363A00000X Physician Assistant |
| Additional Taxonomies | 207Q00000X Family Medicine |
| Enumeration Date | 2021-11-02 |
| Last Update Date | 2021-11-02 |