| NPI | 1245579234 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | THOMAS HUMBER Owner 770-251-4345 |
| Organization Subpart ? | No |
| Primary Taxonomy | 208D00000X General Practice (Licence: GA 67600) |
| Additional Taxonomies | 363LP2300X Nurse Practitioner, Primary Care (Licence: GA 176824) |
| 332B00000X Durable Medical Equipment & Medical Supplies | |
| Enumeration Date | 2013-02-11 |
| Last Update Date | 2014-03-26 |