| NPI | 1275048043 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | AVERAL JOHNSON Owner 770-318-0476 |
| Organization Subpart ? | No |
| Primary Taxonomy | 261QM1300X Clinic/Center, Multi-Specialty (Licence: GA 33177) |
| Additional Taxonomies | 207RS0012X Internal Medicine, Sleep Medicine (Licence: GA 33177) |
| Enumeration Date | 2017-12-03 |
| Last Update Date | 2018-06-20 |