| NPI | 1538553094 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | PHARONDA LEE Insurance Manager 770-822-3031 |
| Organization Subpart ? | No |
| Primary Taxonomy | 207Q00000X Family Medicine |
| Additional Taxonomies | 207R00000X Internal Medicine |
| 208100000X Physical Medicine & Rehabilitation | |
| Enumeration Date | 2015-03-23 |
| Last Update Date | 2015-03-27 |