| NPI | 1114141660 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | MANUEL LOZANO Owner 770-495-7942 |
| Organization Subpart ? | No |
| Primary Taxonomy | 261QM1300X Clinic/Center, Multi-Specialty (Licence: GA 2007000070) |
| Enumeration Date | 2007-04-13 |
| Last Update Date | 2020-08-22 |