| NPI | 1689222747 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | BARBARA R CLARK Nurse Practitioner 770-231-8568 |
| Organization Subpart ? | No |
| Primary Taxonomy | 261QP2300X Clinic/Center Primary Care |
| Additional Taxonomies | 251E00000X Home Health |
| 251F00000X Home Infusion | |
| 261QM1300X Clinic/Center Multi-Specialty | |
| Enumeration Date | 2019-08-30 |
| Last Update Date | 2019-08-30 |