| NPI | 1184376931 | 
|---|---|
| Entity Type | Organization | 
| Authorized Contact | SHANTEL ANTOIN BROWN Owner 770-990-4699 | 
| Organization Subpart ? | No | 
| Primary Taxonomy | 261Q00000X Clinic/Center | 
| Additional Taxonomies | 163W00000X Registered Nurse | 
| 291U00000X Clinical Medical Laboratory | |
| 363LF0000X Nurse Practitioner, Family | |
| Enumeration Date | 2022-01-24 | 
| Last Update Date | 2022-02-16 |