| NPI | 1225477102 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | MICHAEL ANTHONY GIBSON Owner 404-580-7642 |
| Organization Subpart ? | No |
| Primary Taxonomy | 261QH0100X Clinic/Center, Health Services (Licence: GA 057975) |
| Enumeration Date | 2013-06-24 |
| Last Update Date | 2013-06-24 |