| NPI | 1821386855 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | TAREN LAZZARI Vice President 770-265-2772 |
| Organization Subpart ? | No |
| Primary Taxonomy | 207QG0300X Family Medicine, Geriatric Medicine |
| Additional Taxonomies | 2084P0805X |
| Enumeration Date | 2011-07-12 |
| Last Update Date | 2011-07-12 |