| NPI | 1639552649 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | KIMAR DUNN Assistant Practice Manager 678-518-9691 |
| Organization Subpart ? | No |
| Primary Taxonomy | 174400000X Specialist (Licence: GA 57621) |
| Enumeration Date | 2015-07-08 |
| Last Update Date | 2015-07-08 |