| NPI | 1124051636 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | SUSANA VEGA Office Manager 404-207-1860 |
| Organization Subpart ? | No |
| Primary Taxonomy | 261QP2300X Clinic/Center, Primary Care (Licence: GA 053736) |
| Enumeration Date | 2006-07-08 |
| Last Update Date | 2020-08-22 |