| NPI | 1215136890 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | CHRISTINE M FALLER Office Manager 770-581-2191 |
| Organization Subpart ? | No |
| Primary Taxonomy | 174400000X Specialist (Licence: GA 56072) |
| Additional Taxonomies | 111N00000X Chiropractor (Licence: GA CHIR008003) |
| 174400000X Specialist (Licence: GA PT006876) | |
| 207RP1001X Internal Medicine, Pulmonary Disease (Licence: GA 22393) | |
| Enumeration Date | 2007-07-13 |
| Last Update Date | 2015-07-21 |