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 |