| NPI | 1467811265 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | FANNIE CLARK Revenue Recovery Consultant 678-531-9692 |
| Organization Subpart ? | No |
| Primary Taxonomy | 207Q00000X Family Medicine (Licence: GA 17323874) |
| Enumeration Date | 2016-02-22 |
| Last Update Date | 2016-02-22 |