| NPI | 1568628618 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | GORDON GLENN FREEMAN President 770-972-4764 |
| Organization Subpart ? | No |
| Primary Taxonomy | 261QP2300X Clinic/Center Primary Care (Licence: GA 023958) |
| Enumeration Date | 2008-07-29 |
| Last Update Date | 2015-06-10 |