NPI | 1487886123 |
---|---|
Entity Type | Organization |
Authorized Contact | BOLAJI T ODUSINA Medical Director 678-442-0205 |
Organization Subpart ? | No |
Primary Taxonomy | 261QP2300X Clinic/Center, Primary Care (Licence: GA 042380) |
Enumeration Date | 2009-08-13 |
Last Update Date | 2011-02-25 |