| NPI | 1801926381 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | JAWAID AHSAN Owner 678-402-1053 |
| Organization Subpart ? | No |
| Primary Taxonomy | 261QM1300X Clinic/Center, Multi-Specialty (Licence: TN 16896) |
| Enumeration Date | 2007-03-06 |
| Last Update Date | 2012-11-01 |