| NPI | 1730491473 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | SUSAN TANNER Medical Doctor 770-676-6000 |
| Organization Subpart ? | No |
| Primary Taxonomy | 208D00000X General Practice (Licence: GA AT2218116) |
| Additional Taxonomies | 208D00000X General Practice |
| Enumeration Date | 2010-07-10 |
| Last Update Date | 2010-07-10 |