| NPI | 1427430412 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | ROBERT J BURTON President 770-262-0171 |
| Organization Subpart ? | No |
| Primary Taxonomy | 174400000X Specialist (Licence: GA 033643) |
| Additional Taxonomies | 302R00000X Health Maintenance Organization (Licence: GA 033543) |
| Enumeration Date | 2015-06-25 |
| Last Update Date | 2015-06-25 |