| NPI | 1083742175 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | BRUCE J GOULD Md Physician 770-281-5100 |
| Organization Subpart ? | No |
| Primary Taxonomy | 332B00000X Durable Medical Equipment & Medical Supplies (Licence: GA 0741780004) |
| Enumeration Date | 2007-03-01 |
| Last Update Date | 2010-12-01 |