| NPI | 1669658829 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | FAOSAT O ODEMUYIWA Manager 770-960-8855 |
| Organization Subpart ? | No |
| Primary Taxonomy | 261QP2300X Clinic/Center Primary Care (Licence: GA 07-12143) |
| Enumeration Date | 2008-01-17 |
| Last Update Date | 2010-06-30 |