| NPI | 1316498090 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | RICHARD FINN Owner 770-881-8534 |
| Organization Subpart ? | No |
| Primary Taxonomy | 261Q00000X Clinic/Center (Licence: GA 07838) |
| Additional Taxonomies | 261Q00000X Clinic/Center (Licence: GA 2586) |
| 261Q00000X Clinic/Center (Licence: GA 009470) | |
| Enumeration Date | 2016-10-18 |
| Last Update Date | 2016-10-18 |