| NPI | 1114286945 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | FAITH M GRAY President/CEO 770-806-8710 |
| Organization Subpart ? | No |
| Primary Taxonomy | 261QP2300X Clinic/Center, Primary Care (Licence: GA 036165) |
| Enumeration Date | 2012-05-14 |
| Last Update Date | 2012-05-14 |