| NPI | 1487362919 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | MARIA WALLER Managing Member 404-932-7183 |
| Organization Subpart ? | No |
| Primary Taxonomy | 207Q00000X Family Medicine |
| Additional Taxonomies | 261QH0100X Clinic/Center, Health Services |
| Enumeration Date | 2022-11-14 |
| Last Update Date | 2023-12-22 |