| NPI | 1124425483 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | SAMUEL JOHNSON Medical Director 678-704-0306 |
| Organization Subpart ? | No |
| Primary Taxonomy | 207Q00000X Family Medicine (Licence: GA 037486) |
| Enumeration Date | 2014-12-02 |
| Last Update Date | 2014-12-02 |