| NPI | 1790238871 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | PHARONDA LEE Owner 770-822-3031 |
| Organization Subpart ? | No |
| Primary Taxonomy | 207R00000X Internal Medicine |
| Additional Taxonomies | 207VG0400X Obstetrics & Gynecology, Gynecology |
| 207Q00000X Family Medicine | |
| Enumeration Date | 2016-07-26 |
| Last Update Date | 2024-01-31 |