| NPI | 1629354303 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | PAUL WILLIS CEO 770-513-0111 |
| Organization Subpart ? | Yes |
| Primary Taxonomy | 207R00000X Internal Medicine (Licence: GA 58389) |
| Additional Taxonomies | 111N00000X Chiropractor (Licence: GA CHIR004786) |
| 363L00000X Nurse Practitioner (Licence: GA RN051666) | |
| Enumeration Date | 2011-10-26 |
| Last Update Date | 2011-10-26 |