| NPI | 1770891921 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | JOYCE A MCDOUGAL CEO 770-982-1486 |
| Organization Subpart ? | No |
| Primary Taxonomy | 261QH0100X Clinic/Center Health Service (Licence: GA 067011941) |
| Enumeration Date | 2010-09-22 |
| Last Update Date | 2010-09-22 |