| NPI | 1255638094 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | JAMES E PETERZELL Medical Director 770-434-7830 |
| Organization Subpart ? | No |
| Primary Taxonomy | 261QM1300X Clinic/Center, Multi-Specialty (Licence: GA 053868) |
| Enumeration Date | 2011-02-14 |
| Last Update Date | 2011-07-06 |