| NPI | 1821355447 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | REGINA JUSTICE CEO/Owner 678-491-7657 |
| Organization Subpart ? | No |
| Primary Taxonomy | 208000000X Pediatrics |
| Additional Taxonomies | 261QP2300X Clinic/Center, Primary Care (Licence: GA 47777) |
| Enumeration Date | 2012-04-20 |
| Last Update Date | 2023-03-07 |