| NPI | 1184980336 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | EZEKIEL WALTER HOOD Medical Director 770-964-0611 |
| Organization Subpart ? | No |
| Primary Taxonomy | 261QM2500X Clinic/Center, Medical Specialty (Licence: GA 8797) |
| Enumeration Date | 2012-04-02 |
| Last Update Date | 2012-04-02 |