| NPI | 1306019104 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | BENNIE RUSSELL WHITE President 770-775-2341 |
| Organization Subpart ? | No |
| Primary Taxonomy | 261QP2300X Clinic/Center, Primary Care (Licence: GA 56245) |
| Enumeration Date | 2008-04-12 |
| Last Update Date | 2008-04-12 |