| NPI | 1326218140 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | ROBERT A BURKICH Medical Director 770-368-8787 |
| Organization Subpart ? | No |
| Primary Taxonomy | 305S00000X Point of Service (Licence: GA 46372) |
| Enumeration Date | 2008-03-07 |
| Last Update Date | 2008-03-07 |