| NPI | 1154791820 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | KEVIN KAZAKEVICH Owner 404-944-6548 |
| Organization Subpart ? | No |
| Primary Taxonomy | 261QH0100X Clinic/Center, Health Services (Licence: GA CHIR009027) |
| Enumeration Date | 2015-10-06 |
| Last Update Date | 2015-10-06 |