| NPI | 1356193635 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | JASMINE THARPE Director 470-782-2770 |
| Organization Subpart ? | No |
| Primary Taxonomy | 261QP2300X Clinic/Center, Primary Care |
| Additional Taxonomies | 207Q00000X Family Medicine |
| Enumeration Date | 2024-04-02 |
| Last Update Date | 2024-04-25 |