| NPI | 1346462801 |
|---|---|
| Doing Business As | IVY RIDGE PEDIATRICS |
| Entity Type | Organization |
| Authorized Contact | WILLIAM TOD KEYS Office Manager 770-205-7799 |
| Organization Subpart ? | No |
| Primary Taxonomy | 208000000X Pediatrics |
| Enumeration Date | 2007-05-03 |
| Last Update Date | 2008-06-25 |