| NPI | 1366714040 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | ANTHONY HUMAN Chief Medical Officer 678-404-9585 |
| Organization Subpart ? | No |
| Primary Taxonomy | 261Q00000X Clinic/Center (Licence: GA 056072) |
| Enumeration Date | 2012-01-27 |
| Last Update Date | 2012-01-27 |