| NPI | 1346514650 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | JEANNE HANLIN Manager 770-534-0656 |
| Organization Subpart ? | Yes |
| Primary Taxonomy | 207QA0505X Family Medicine, Adult Medicine |
| Additional Taxonomies | 111N00000X Chiropractor |
| 363L00000X Nurse Practitioner | |
| Enumeration Date | 2012-03-05 |
| Last Update Date | 2012-03-05 |