NPI | 1477872760 |
---|---|
Entity Type | Organization |
Authorized Contact | WILLIAM PAUL CFO 770-716-2680 |
Organization Subpart ? | No |
Primary Taxonomy | 302F00000X Exclusive Provider Organization (Licence: GA 60026) |
Enumeration Date | 2010-05-26 |
Last Update Date | 2010-05-26 |