| NPI | 1467732834 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | JEREMY SIMMS ALEXANDER CEO 770-642-4711 |
| Organization Subpart ? | No |
| Primary Taxonomy | 305R00000X Preferred Provider Organization (Licence: GA DN013652) |
| Enumeration Date | 2011-08-17 |
| Last Update Date | 2011-08-17 |