| NPI | 1568517720 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | DEBBIE DEAN Office Manager 770-422-0444 |
| Organization Subpart ? | No |
| Primary Taxonomy | 174400000X Specialist (Licence: GA 34376) |
| Additional Taxonomies | 174400000X Specialist (Licence: GA 003649) |
| Enumeration Date | 2007-01-25 |
| Last Update Date | 2010-02-08 |