| NPI | 1114686052 |
|---|---|
| Other Name | VILLAGE MEDICAL - VISTA EAST |
| Entity Type | Organization |
| Authorized Contact | KRISTI I LEE Dir Rev Cycle 706-513-4897 |
| Organization Subpart ? | Yes |
| Primary Taxonomy | 207Q00000X Family Medicine |
| Additional Taxonomies | 207R00000X Internal Medicine |
| Enumeration Date | 2021-12-08 |
| Last Update Date | 2021-12-08 |