| NPI | 1710267505 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | KHAWAJA RAZA MAHMOOD Sole Proprietor 706-253-9898 |
| Organization Subpart ? | No |
| Primary Taxonomy | 261QP2300X Clinic/Center Primary Care (Licence: GA 42648) |
| Enumeration Date | 2011-08-24 |
| Last Update Date | 2011-08-24 |