| NPI | 1821330648 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | LATOYA BENITA STEPHENS Owner/Physician 770-683-9136 |
| Organization Subpart ? | No |
| Primary Taxonomy | 261QM2500X Clinic/Center, Medical Specialty (Licence: GA 58512) |
| Enumeration Date | 2013-03-19 |
| Last Update Date | 2022-03-10 |