| NPI | 1487782942 |
|---|---|
| Former Legal Business Name | PEACHTREE PEDIATRIC CLINIC, P.A. |
| Entity Type | Organization |
| Authorized Contact | KATHRYN GIBSON WAGGONER Owner 828-837-2128 |
| Organization Subpart ? | No |
| Primary Taxonomy | 208000000X Pediatrics |
| Enumeration Date | 2007-02-28 |
| Last Update Date | 2016-09-12 |