| NPI | 1619256674 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | SARA BADIE Billing Manager 770-876-6964 |
| Organization Subpart ? | No |
| Primary Taxonomy | 305R00000X Preferred Provider Organization (Licence: GA chir002610) |
| Enumeration Date | 2011-08-09 |
| Last Update Date | 2011-08-09 |