| NPI | 1235871013 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | ABIDEMI MARSH Owner 404-644-4198 |
| Organization Subpart ? | No |
| Primary Taxonomy | 261Q00000X |
| Additional Taxonomies | 261QC1800X |
| 261QM0801X | |
| 261QS1000X Clinic/Center, Student Health | |
| Enumeration Date | 2022-04-11 |
| Last Update Date | 2022-04-11 |