| NPI | 1275035578 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | JASON THADEOUS HAYES Owner, President, General Manager 678-395-7046 |
| Organization Subpart ? | Yes |
| Primary Taxonomy | 207R00000X Internal Medicine (Licence: GA 69293) |
| Enumeration Date | 2018-03-02 |
| Last Update Date | 2021-07-16 |