NPI | 1427407428 |
---|---|
Entity Type | Organization |
Authorized Contact | JEFFREY A DONOHUE Owner 770-402-9602 |
Organization Subpart ? | No |
Primary Taxonomy | 261QP2300X Clinic/Center, Primary Care (Licence: AL MD17416) |
Enumeration Date | 2016-06-09 |
Last Update Date | 2016-06-09 |