| NPI | 1124621487 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | JAMES KINGSLEY Owner 770-580-1905 |
| Organization Subpart ? | No |
| Primary Taxonomy | 207R00000X Internal Medicine |
| Additional Taxonomies | 261QP2300X Clinic/Center Primary Care |
| Enumeration Date | 2020-11-19 |
| Last Update Date | 2024-01-31 |