| NPI | 1134501422 | 
|---|---|
| Entity Type | Organization | 
| Authorized Contact | NICOLE ASHE Executive Director Of Finance 470-644-0095  | 
| Organization Subpart ? | No | 
| Primary Taxonomy | 261QM1300X Clinic/Center, Multi-Specialty | 
| Enumeration Date | 2015-06-23 | 
| Last Update Date | 2020-02-24 |