| NPI | 1821480351 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | KIRPICH JOSEPH Authorized Official 770-923-4433 |
| Organization Subpart ? | No |
| Primary Taxonomy | 207Q00000X Family Medicine (Licence: FL ACN 278) |
| Enumeration Date | 2015-02-20 |
| Last Update Date | 2024-12-10 |