| NPI | 1770325151 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | CATHRYN BONAR Compliance Officer 404-416-3905 |
| Organization Subpart ? | No |
| Primary Taxonomy | 332B00000X Durable Medical Equipment & Medical Supplies |
| Additional Taxonomies | 261QD0000X Clinic/Center, Dental |
| Enumeration Date | 2024-06-07 |
| Last Update Date | 2024-06-10 |