| NPI | 1538559729 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | DONNA SEWELL Owner 404-245-1344 |
| Organization Subpart ? | No |
| Primary Taxonomy | 305R00000X Preferred Provider Organization (Licence: GA CSW003818) |
| Enumeration Date | 2015-01-27 |
| Last Update Date | 2015-01-27 |