| NPI | 1366497398 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | IMANI D. VANNOY Doctor 770-977-5355 |
| Organization Subpart ? | No |
| Primary Taxonomy | 261QP2300X Clinic/Center, Primary Care (Licence: GA 024225) |
| Enumeration Date | 2006-05-25 |
| Last Update Date | 2009-08-10 |