| NPI | 1730555269 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | MARYANN SHERBER Practice Manager 770-255-1069 |
| Organization Subpart ? | No |
| Primary Taxonomy | 363LA2200X Nurse Practitioner, Adult Health (Licence: GA RN088988) |
| Enumeration Date | 2015-08-19 |
| Last Update Date | 2015-08-19 |