| NPI | 1689704108 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | GILBERT OSBORNE Insurance Coordinator 770-719-4949 |
| Organization Subpart ? | No |
| Primary Taxonomy | 302R00000X Health Maintenance Organization |
| Enumeration Date | 2007-03-06 |
| Last Update Date | 2011-10-12 |