| NPI | 1174834980 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | JEFF MITCHAM COO 770-914-0116 |
| Organization Subpart ? | No |
| Primary Taxonomy | 261QR0200X Clinic/Center, Radiology (Licence: GA 29378) |
| Additional Taxonomies | 207Q00000X Family Medicine (Licence: GA 29378) |
| Enumeration Date | 2010-06-25 |
| Last Update Date | 2020-02-06 |