| NPI | 1598719007 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | JACEK EUSTACHY LYSZKOWICZ Owner 770-922-9622 |
| Organization Subpart ? | No |
| Primary Taxonomy | 207Q00000X Family Medicine (Licence: GA 047113) |
| Enumeration Date | 2006-05-20 |
| Last Update Date | 2008-04-24 |