| NPI | 1326387820 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | RAY B BENNETT Director 770-692-7575 |
| Organization Subpart ? | No |
| Primary Taxonomy | 207Q00000X Family Medicine |
| Additional Taxonomies | 207Q00000X Family Medicine |
| 261QP2300X Clinic/Center Primary Care (Licence: GA 056526) | |
| Enumeration Date | 2013-02-05 |
| Last Update Date | 2024-03-28 |