| NPI | 1699367367 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | PAULA RICHARDSON Owner 678-578-8449 |
| Organization Subpart ? | No |
| Primary Taxonomy | 363LF0000X Nurse Practitioner, Family |
| Additional Taxonomies | 291U00000X Clinical Medical Laboratory |
| Enumeration Date | 2021-02-04 |
| Last Update Date | 2021-03-23 |