| NPI | 1346368149 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | VICKI D KNIGHT-MATHIS Owner 770-704-0057 |
| Organization Subpart ? | No |
| Primary Taxonomy | 261QP2300X Clinic/Center, Primary Care (Licence: GA 047337) |
| Enumeration Date | 2007-03-27 |
| Last Update Date | 2020-08-22 |