| NPI | 1447567631 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | SRIDEVI SIRUVELLA Medical Director/Physician 770-266-0567 |
| Organization Subpart ? | No |
| Primary Taxonomy | 207Q00000X Family Medicine (Licence: GA 057019) |
| Enumeration Date | 2010-09-09 |
| Last Update Date | 2010-09-10 |