| NPI | 1548606767 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | JAMES K IRUNGU Billing Manager 678-353-7073 |
| Organization Subpart ? | No |
| Primary Taxonomy | 207Q00000X Family Medicine (Licence: WI 42218-20) |
| Additional Taxonomies | 207QA0401X Family Medicine, Addiction Medicine (Licence: WI 42218-20) |
| Enumeration Date | 2013-05-14 |
| Last Update Date | 2013-05-14 |