| NPI | 1669909172 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | TONYA LEWIS Owner 478-559-1386 |
| Organization Subpart ? | No |
| Primary Taxonomy | 261QP2300X Clinic/Center, Primary Care (Licence: GA RN118481) |
| Enumeration Date | 2017-05-15 |
| Last Update Date | 2023-07-19 |