| NPI | 1699352179 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | RA'KESHIA BROGDON Credentialing Specialist 678-783-7619 |
| Organization Subpart ? | Yes |
| Primary Taxonomy | 261QR0200X Clinic/Center, Radiology |
| Enumeration Date | 2021-03-29 |
| Last Update Date | 2021-03-29 |