| NPI | 1174838551 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | ANNIE JOHNSON Insurance COO Rdinator 678-289-8184 |
| Organization Subpart ? | No |
| Primary Taxonomy | 208000000X Pediatrics (Licence: GA 045647) |
| Enumeration Date | 2010-08-10 |
| Last Update Date | 2010-08-10 |