NPI | 1386078152 |
---|---|
Entity Type | Organization |
Authorized Contact | DEEDEE VARNER Practice Administrator 678-504-1199 |
Organization Subpart ? | No |
Primary Taxonomy | 2080A0000X Pediatrics, Adolescent Medicine |
Enumeration Date | 2013-08-28 |
Last Update Date | 2013-08-28 |