| NPI | 1316320120 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | ORIE JENKINS President 404-229-6222 |
| Organization Subpart ? | No |
| Primary Taxonomy | 111NR0400X |
| Additional Taxonomies | 261QP2300X Clinic/Center, Primary Care (Licence: GA 040613) |
| Enumeration Date | 2015-06-30 |
| Last Update Date | 2021-04-23 |