NPI | 1457500837 |
---|---|
Entity Type | Organization |
Authorized Contact | BRENDA C. FITZGERALD Physician 770-838-5828 |
Organization Subpart ? | No |
Primary Taxonomy | 305R00000X Preferred Provider Organization (Licence: GA D29480) |
Enumeration Date | 2008-09-10 |
Last Update Date | 2008-09-10 |