| NPI | 1265880348 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | TORY M BANKS Nurse Practitioner 770-564-1121 |
| Organization Subpart ? | No |
| Primary Taxonomy | 261QP2300X Clinic/Center Primary Care (Licence: GA F0216972) |
| Enumeration Date | 2016-05-30 |
| Last Update Date | 2016-05-30 |