| NPI | 1609259969 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | MIGUELITA BHUIYAN Administrator 770-990-6811 |
| Organization Subpart ? | No |
| Primary Taxonomy | 207Q00000X Family Medicine (Licence: GA 067173) |
| Enumeration Date | 2015-07-06 |
| Last Update Date | 2015-07-06 |