| NPI | 1164828281 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | GREGORY MESA Owner 404-500-6372 |
| Organization Subpart ? | No |
| Primary Taxonomy | 207QG0300X Family Medicine, Geriatric Medicine (Licence: CO 48078) |
| Enumeration Date | 2014-11-17 |
| Last Update Date | 2014-11-17 |