NPI | 1699429027 |
---|---|
Entity Type | Organization |
Authorized Contact | RICHO GLADNEY Owner 470-925-6802 |
Organization Subpart ? | No |
Primary Taxonomy | 261Q00000X Clinic/Center |
Additional Taxonomies | 207QG0300X Family Medicine, Geriatric Medicine |
207R00000X Internal Medicine | |
208000000X Pediatrics | |
208D00000X General Practice | |
Enumeration Date | 2022-02-04 |
Last Update Date | 2022-02-04 |