| NPI | 1356738447 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | ANGELA PATRICE SHANNON Director 404-346-8264 |
| Organization Subpart ? | No |
| Primary Taxonomy | 261QH0100X Clinic/Center Health Service (Licence: GA 036661) |
| Enumeration Date | 2015-04-16 |
| Last Update Date | 2015-04-16 |