| NPI | 1467611129 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | NANCY STEVENSON Office Manager 770-988-9200 |
| Organization Subpart ? | No |
| Primary Taxonomy | 207QA0401X Family Medicine, Addiction Medicine (Licence: GA GEORGIA031313) |
| Enumeration Date | 2008-06-06 |
| Last Update Date | 2009-12-22 |