| NPI | 1629888474 |
|---|---|
| Doing Business As | BLACK TIE HEALTH |
| Entity Type | Organization |
| Authorized Contact | JEREMIAS DUARTE Physician 770-559-3186 |
| Organization Subpart ? | No |
| Primary Taxonomy | 208D00000X General Practice |
| Enumeration Date | 2025-01-13 |
| Last Update Date | 2025-01-13 |