| NPI | 1386919280 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | LAURA RESTREPO Administrator 770-594-3438 |
| Organization Subpart ? | No |
| Primary Taxonomy | 261QP2300X Clinic/Center Primary Care |
| Additional Taxonomies | 261QC1500X Clinic/Center Community Health |
| 261QM1300X Clinic/Center Multi-Specialty | |
| 261QP2000X Clinic/Center Physical Therapy | |
| 261QR1100X Clinic/Center Research | |
| 261QU0200X Clinic/Center Urgent Care | |
| Enumeration Date | 2012-03-12 |
| Last Update Date | 2012-03-12 |