| NPI | 1386917425 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | JOSEPH L MICCA Owner 770-888-2524 |
| Organization Subpart ? | No |
| Primary Taxonomy | 207RG0300X Internal Medicine, Geriatric Medicine (Licence: GA 39179) |
| Enumeration Date | 2012-02-21 |
| Last Update Date | 2012-02-21 |