| NPI | 1407902638 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | LAURIE ANN KELLEY Practice Manager 770-233-9293 |
| Organization Subpart ? | No |
| Primary Taxonomy | 173000000X Legal Medicine (Licence: GA 044231) |
| Additional Taxonomies | 174400000X Specialist (Licence: GA 031590) |
| Enumeration Date | 2007-01-29 |
| Last Update Date | 2020-08-22 |