| NPI | 1083819429 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | TRACEY BLANDER Practice Management Consultant 770-716-6203 |
| Organization Subpart ? | No |
| Primary Taxonomy | 207V00000X Obstetrics & Gynecology (Licence: GA 054127) |
| Enumeration Date | 2007-06-17 |
| Last Update Date | 2020-03-04 |