| NPI | 1679769582 |
|---|---|
| Doing Business As | FAMILY |
| Entity Type | Organization |
| Authorized Contact | AVA ALICIA LOVEERING Administrator 770-921-7007 |
| Organization Subpart ? | No |
| Primary Taxonomy | 207Q00000X Family Medicine (Licence: GA 045753) |
| Enumeration Date | 2007-09-25 |
| Last Update Date | 2007-09-25 |