| NPI | 1154864841 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | BRUCE J. GOULD M.D./ Medical Director 770-281-5100 |
| Organization Subpart ? | No |
| Primary Taxonomy | 332B00000X Durable Medical Equipment & Medical Supplies |
| Enumeration Date | 2016-11-29 |
| Last Update Date | 2017-01-04 |