| NPI | 1629644414 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | MEREDITH BERRYMAN CFO 678-642-3843 |
| Organization Subpart ? | No |
| Primary Taxonomy | 261QH0100X Clinic/Center, Health Services |
| Additional Taxonomies | 305S00000X Point of Service |
| Enumeration Date | 2021-06-02 |
| Last Update Date | 2021-06-02 |