| NPI | 1225840069 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | ERIC J ROBERTS President 678-910-8116 |
| Organization Subpart ? | No |
| Primary Taxonomy | 363LP2300X Nurse Practitioner, Primary Care |
| Additional Taxonomies | 213EP1101X Podiatrist, Primary Podiatric Medicine |
| Enumeration Date | 2025-01-20 |
| Last Update Date | 2025-01-20 |