| NPI | 1710310636 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | MELINDA LASSITER Office Manager 770-985-2900 |
| Organization Subpart ? | No |
| Primary Taxonomy | 207QA0505X Family Medicine, Adult Medicine (Licence: GA 10220) |
| Enumeration Date | 2013-08-14 |
| Last Update Date | 2013-08-14 |