| NPI | 1093028623 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | HAILEY ELIZABETH HEARD Owner 678-628-9925 |
| Organization Subpart ? | No |
| Primary Taxonomy | 261Q00000X Clinic/Center (Licence: GA CHIR008692) |
| Enumeration Date | 2010-07-25 |
| Last Update Date | 2010-07-25 |