| NPI | 1629246137 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | KENNETH R WARNER Billing 770-458-1594 |
| Organization Subpart ? | No |
| Primary Taxonomy | 2084P0800X Psychiatry & Neurology, Psychiatry (Licence: GA 046593) |
| Enumeration Date | 2008-02-19 |
| Last Update Date | 2008-02-19 |