| NPI | 1134522774 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | JESSE ANDERSON Director Of Operations 404-382-9608 |
| Organization Subpart ? | No |
| Primary Taxonomy | 363A00000X Physician Assistant (Licence: GA 6242) |
| Enumeration Date | 2014-09-26 |
| Last Update Date | 2014-09-26 |