NPI | 1164940672 |
---|---|
Entity Type | Organization |
Authorized Contact | BRIDGETTE HANNIGAN Chief Executive Officer 678-755-5334 |
Organization Subpart ? | No |
Primary Taxonomy | 261QP2300X Clinic/Center, Primary Care |
Additional Taxonomies | 261Q00000X Clinic/Center |
Enumeration Date | 2017-09-05 |
Last Update Date | 2022-07-21 |