| NPI | 1780327346 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | TEMEKA L JOHNSON Np 678-324-8009 |
| Organization Subpart ? | No |
| Primary Taxonomy | 207Q00000X Family Medicine |
| Additional Taxonomies | 164W00000X Licensed Practical Nurse |
| Enumeration Date | 2022-04-20 |
| Last Update Date | 2024-10-04 |