| NPI | 1538874557 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | TIFFANY MASTIN Owner/Administrator 404-922-1985 |
| Organization Subpart ? | No |
| Primary Taxonomy | 261QH0100X Clinic/Center Health Service |
| Additional Taxonomies | 291U00000X Clinical Medical Laboratory |
| Enumeration Date | 2023-01-16 |
| Last Update Date | 2023-01-16 |