| NPI | 1326491242 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | NATASHA CLOUD Business Manager 404-768-2887 |
| Organization Subpart ? | No |
| Primary Taxonomy | 305R00000X Preferred Provider Organization (Licence: GA 9084) |
| Enumeration Date | 2016-07-15 |
| Last Update Date | 2016-07-15 |