| NPI | 1669526604 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | DORISE A HOUSE Insurance Manager 770-479-1494 |
| Organization Subpart ? | No |
| Primary Taxonomy | 207Q00000X Family Medicine (Licence: GA 015374) |
| Enumeration Date | 2007-01-23 |
| Last Update Date | 2009-12-29 |