| NPI | 1215251640 |
|---|---|
| Doing Business As | EARLY DETECTION INTERVENTION CLINIC |
| Entity Type | Organization |
| Authorized Contact | RONNIE E BASS Executive Director 678-921-2706 |
| Organization Subpart ? | No |
| Primary Taxonomy | 261QM1300X Clinic/Center, Multi-Specialty |
| Enumeration Date | 2010-03-14 |
| Last Update Date | 2023-03-17 |