| NPI | 1740547033 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | TIFFANY CHASE Patient Account Analyst 404-778-7988 |
| Organization Subpart ? | No |
| Primary Taxonomy | 305R00000X Preferred Provider Organization |
| Enumeration Date | 2012-04-12 |
| Last Update Date | 2012-04-12 |