| NPI | 1184891400 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | LAWRENCE VINCENT POOLD Office Manager 770-499-8909 |
| Organization Subpart ? | No |
| Primary Taxonomy | 261QP2300X Clinic/Center, Primary Care (Licence: GA 047011) |
| Enumeration Date | 2008-05-15 |
| Last Update Date | 2014-07-07 |