| NPI | 1760404701 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | SUSAN ULMER DEWOLF President / CEO 678-488-7299 |
| Organization Subpart ? | No |
| Primary Taxonomy | 363LA2200X Nurse Practitioner, Adult Health (Licence: GA RN097274) |
| Enumeration Date | 2006-07-25 |
| Last Update Date | 2020-08-22 |