| NPI | 1487849857 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | ELIZABETH MIKRUT President 770-554-5533 |
| Organization Subpart ? | No |
| Primary Taxonomy | 261QP2300X Clinic/Center, Primary Care (Licence: GA 29730) |
| Enumeration Date | 2007-09-10 |
| Last Update Date | 2007-09-21 |