| NPI | 1669796090 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | UVIENOME LINDA SAKOR Nurse Practitioner 678-383-6944 |
| Organization Subpart ? | No |
| Primary Taxonomy | 261Q00000X Clinic/Center (Licence: GA 159225) |
| Enumeration Date | 2010-03-13 |
| Last Update Date | 2012-06-05 |