| NPI | 1497083083 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | DAVID L WIZNITZER Member 770-521-8994 |
| Organization Subpart ? | No |
| Primary Taxonomy | 207Q00000X Family Medicine |
| Additional Taxonomies | 208D00000X General Practice |
| 332B00000X Durable Medical Equipment & Medical Supplies | |
| Enumeration Date | 2009-11-19 |
| Last Update Date | 2010-08-20 |