| NPI | 1750536819 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | SANDY WAGES BALLARD Owner 678-458-2011 |
| Organization Subpart ? | No |
| Primary Taxonomy | 261QH0100X Clinic/Center, Health Services (Licence: GA 147-01-013-1) |
| Enumeration Date | 2008-11-17 |
| Last Update Date | 2008-11-17 |