| NPI | 1821114000 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | JULIE MORRIS Business Manager 770-941-5107 |
| Organization Subpart ? | No |
| Primary Taxonomy | 261QP2300X Clinic/Center, Primary Care (Licence: GA 2005-7681) |
| Enumeration Date | 2007-03-21 |
| Last Update Date | 2020-08-22 |