| NPI | 1518302140 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | AMY BOLDEN Practice Administrator 770-772-4233 |
| Organization Subpart ? | No |
| Primary Taxonomy | 207Q00000X Family Medicine (Licence: GA 58737) |
| Enumeration Date | 2013-05-09 |
| Last Update Date | 2013-05-09 |