| NPI | 1194274951 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | KELLY GARDNER RICH CEO 678-859-1483 |
| Organization Subpart ? | No |
| Primary Taxonomy | 261QP2300X Clinic/Center Primary Care (Licence: GA 047988) |
| Enumeration Date | 2016-09-22 |
| Last Update Date | 2016-09-22 |