| NPI | 1801543459 |
|---|---|
| Doing Business As | ATLANTA - BUCKHEAD |
| Entity Type | Organization |
| Authorized Contact | AUSTIN GEORGE BENAMON CEO 866-806-5347 |
| Organization Subpart ? | Yes |
| Primary Taxonomy | 261QM1300X Clinic/Center, Multi-Specialty |
| Enumeration Date | 2022-03-03 |
| Last Update Date | 2022-03-03 |