| NPI | 1538458690 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | DEBORAH LYN LEVICH CEO 678-218-1710 |
| Organization Subpart ? | No |
| Primary Taxonomy | 261QM2500X Clinic/Center, Medical Specialty (Licence: GA 044520) |
| Enumeration Date | 2011-03-29 |
| Last Update Date | 2011-03-29 |