| NPI | 1689017170 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | ESMERARDO CRUZ MORALES Owner/Provider 678-521-1624 |
| Organization Subpart ? | No |
| Primary Taxonomy | 261QP2300X Clinic/Center, Primary Care (Licence: GA 00227204) |
| Enumeration Date | 2013-04-15 |
| Last Update Date | 2013-04-15 |