| NPI | 1710286414 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | JOHN WILLIAM BUDELL Owner 770-496-2929 |
| Organization Subpart ? | No |
| Primary Taxonomy | 261QM2500X Clinic/Center, Medical Specialty (Licence: GA 017369) |
| Enumeration Date | 2011-03-21 |
| Last Update Date | 2011-03-21 |