| NPI | 1528899135 | 
|---|---|
| Doing Business As | SAMARITAN CLINIC | 
| Entity Type | Organization | 
| Authorized Contact | NEDRA S FORTSON Executive Director 770-330-8496 | 
| Organization Subpart ? | No | 
| Primary Taxonomy | 207Q00000X Family Medicine | 
| Enumeration Date | 2024-08-13 | 
| Last Update Date | 2024-08-13 |