| NPI | 1124792106 |
|---|---|
| Doing Business As | MINI-MED CLINIC OF NORTH GEORGIA |
| Entity Type | Organization |
| Authorized Contact | SOPHIA KENNEDY Nurse Practitioner 678-398-9697 |
| Organization Subpart ? | No |
| Primary Taxonomy | 261Q00000X |
| Enumeration Date | 2021-08-04 |
| Last Update Date | 2021-08-27 |