| NPI | 1700183357 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | MARY LEACH Billing Supervisor 770-676-6000 |
| Organization Subpart ? | No |
| Primary Taxonomy | 208D00000X General Practice |
| Additional Taxonomies | 207Q00000X Family Medicine |
| Enumeration Date | 2011-02-17 |
| Last Update Date | 2011-05-18 |