| NPI | 1225133796 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | LISA M. ROSA-RE Owner/Physician 678-325-6611 |
| Organization Subpart ? | No |
| Primary Taxonomy | 207Q00000X Family Medicine (Licence: GA 029768) |
| Enumeration Date | 2006-09-13 |
| Last Update Date | 2013-12-02 |