| NPI | 1619493939 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | SHERNITTA COOPER Medical Biller 470-244-4644 |
| Organization Subpart ? | No |
| Primary Taxonomy | 261QP2300X Clinic/Center Primary Care |
| Additional Taxonomies | 207QA0505X Family Medicine Adult Medicine |
| Enumeration Date | 2017-08-17 |
| Last Update Date | 2022-07-21 |