| NPI | 1538346408 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | BONITA AGNES CHARLES Director 678-565-0574 |
| Organization Subpart ? | No |
| Primary Taxonomy | 163W00000X Registered Nurse (Licence: GA RN187342) |
| Enumeration Date | 2008-01-23 |
| Last Update Date | 2008-06-20 |