| NPI | 1497897631 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | JACKIE L. WILLIAMSON Owner 770-926-9846 |
| Organization Subpart ? | No |
| Primary Taxonomy | 261QP2300X Clinic/Center, Primary Care |
| Additional Taxonomies | 207Q00000X Family Medicine |
| Enumeration Date | 2007-02-13 |
| Last Update Date | 2019-08-01 |