| NPI | 1215696869 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | ELLA STEPHENSON Administrator 470-545-0860 |
| Organization Subpart ? | No |
| Primary Taxonomy | 208D00000X General Practice |
| Additional Taxonomies | 261QI0500X Clinic/Center, Infusion Therapy |
| Enumeration Date | 2021-12-10 |
| Last Update Date | 2023-04-17 |