| NPI | 1821356528 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | CAROL ANN LYLE Secretary 770-506-8187 |
| Organization Subpart ? | No |
| Primary Taxonomy | 2084P0800X Psychiatry & Neurology Psychiatry (Licence: GA 024707) |
| Enumeration Date | 2012-05-01 |
| Last Update Date | 2012-05-01 |