| NPI | 1578111910 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | SHANTEL BRYANT Owner 770-629-4374 |
| Organization Subpart ? | No |
| Primary Taxonomy | 207Q00000X Family Medicine |
| Additional Taxonomies | 207R00000X Internal Medicine |
| 291U00000X Clinical Medical Laboratory | |
| 363L00000X Nurse Practitioner | |
| Enumeration Date | 2019-08-29 |
| Last Update Date | 2021-06-21 |