| NPI | 1225169071 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | VICKI J. DANIEL Administrator 770-944-0811 |
| Organization Subpart ? | No |
| Primary Taxonomy | 207R00000X Internal Medicine (Licence: GA 038362) |
| Enumeration Date | 2007-03-07 |
| Last Update Date | 2013-04-19 |