| NPI | 1598338980 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | NAVEEDA TABASSUM AHMED Authorized Official 706-305-9500 |
| Organization Subpart ? | No |
| Primary Taxonomy | 261QM2500X Clinic/Center Medical Specialty |
| Enumeration Date | 2021-07-22 |
| Last Update Date | 2021-08-03 |