| NPI | 1659685808 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | TIMOTHY BROWN Owner 404-388-8405 |
| Organization Subpart ? | No |
| Primary Taxonomy | 305S00000X Point of Service |
| Additional Taxonomies | 305S00000X Point of Service |
| Enumeration Date | 2010-07-29 |
| Last Update Date | 2022-07-21 |