| NPI | 1770995946 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | DORIS LYNN NGUENGUE-SOWA Credentialing Manager 404-293-4163 |
| Organization Subpart ? | No |
| Primary Taxonomy | 261QP2300X Clinic/Center, Primary Care (Licence: GA 59834) |
| Enumeration Date | 2014-05-22 |
| Last Update Date | 2016-01-19 |