| NPI | 1629420260 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | THINH NGUYEN Physician 678-515-0688 |
| Organization Subpart ? | No |
| Primary Taxonomy | 261QP2300X Clinic/Center, Primary Care (Licence: GA 62402) |
| Enumeration Date | 2016-07-07 |
| Last Update Date | 2016-07-07 |