| NPI | 1225318405 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | MO SWEENEY Owner 678-677-7367 |
| Organization Subpart ? | No |
| Primary Taxonomy | 207K00000X Allergy & Immunology (Licence: GA NA) |
| Additional Taxonomies | 111N00000X Chiropractor (Licence: GA NA) |
| 261QM2500X Clinic/Center, Medical Specialty (Licence: GA NA) | |
| 261QP2300X Clinic/Center, Primary Care (Licence: GA NA) | |
| Enumeration Date | 2011-08-19 |
| Last Update Date | 2011-08-19 |