| NPI | 1134414105 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | CHARLES JENKINS Nurse Practitioner 404-366-3647 |
| Organization Subpart ? | No |
| Primary Taxonomy | 261QP2300X Clinic/Center, Primary Care (Licence: GA RN143268) |
| Enumeration Date | 2011-06-17 |
| Last Update Date | 2011-06-17 |