| NPI | 1366972523 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | TIFFANY LEE Physician 470-236-8379 |
| Organization Subpart ? | No |
| Primary Taxonomy | 261QP2300X Clinic/Center, Primary Care (Licence: GA 046882) |
| Enumeration Date | 2017-06-19 |
| Last Update Date | 2022-07-21 |