| NPI | 1124126420 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | MARIAN LEE WEST Office Administrator 770-972-4871 |
| Organization Subpart ? | No |
| Primary Taxonomy | 207Q00000X Family Medicine (Licence: GA 028915) |
| Enumeration Date | 2006-09-20 |
| Last Update Date | 2020-08-22 |