| NPI | 1386908739 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | LAURA E DAVIDSON Owner 770-366-1229 |
| Organization Subpart ? | No |
| Primary Taxonomy | 261QP2300X Clinic/Center, Primary Care (Licence: GA 028960) |
| Enumeration Date | 2012-06-30 |
| Last Update Date | 2012-06-30 |