| NPI | 1588827166 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | MARLA BENNETT Office Manager 770-996-7622 |
| Organization Subpart ? | No |
| Primary Taxonomy | 207R00000X Internal Medicine (Licence: GA 0510780) |
| Enumeration Date | 2008-07-03 |
| Last Update Date | 2008-07-03 |