| NPI | 1639598089 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | SHAHEEN NOORANI Owner/Member 706-277-4799 |
| Organization Subpart ? | No |
| Primary Taxonomy | 261QM2500X Clinic/Center, Medical Specialty (Licence: GA 042678) |
| Enumeration Date | 2014-04-14 |
| Last Update Date | 2014-04-14 |