| 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 |