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 |