| NPI | 1184879843 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | MICHELLE LYNN PLASTER Physician/Director 770-464-0280 |
| Organization Subpart ? | No |
| Primary Taxonomy | 207Q00000X Family Medicine (Licence: GA 061639) |
| Enumeration Date | 2008-11-22 |
| Last Update Date | 2015-09-04 |