| NPI | 1255085130 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | CHARLIE CAMPBELL COO 770-353-9660 |
| Organization Subpart ? | No |
| Primary Taxonomy | 261Q00000X Clinic/Center |
| Additional Taxonomies | 207Q00000X Family Medicine |
| Enumeration Date | 2022-02-09 |
| Last Update Date | 2023-02-08 |