| NPI | 1386884138 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | VERNA A THORNTON Owner 770-486-0353 |
| Organization Subpart ? | No |
| Primary Taxonomy | 261QM2500X Clinic/Center, Medical Specialty (Licence: GA 034512) |
| Enumeration Date | 2009-03-05 |
| Last Update Date | 2009-03-05 |