| NPI | 1801159298 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | BEVERLY IDRIS Nurse 770-256-7033 |
| Organization Subpart ? | No |
| Primary Taxonomy | 261QM1300X Clinic/Center, Multi-Specialty (Licence: GA 026238) |
| Enumeration Date | 2012-06-20 |
| Last Update Date | 2012-06-20 |