| NPI | 1538495742 | 
|---|---|
| Entity Type | Organization | 
| Authorized Contact | ESTEBAN GUADERRAMA Practice Administrator 770-844-3242  | 
| Organization Subpart ? | No | 
| Primary Taxonomy | 261QM2500X Clinic/Center, Medical Specialty (Licence: GA 031835)  | 
| Enumeration Date | 2009-10-22 | 
| Last Update Date | 2021-06-09 |