| NPI | 1821894601 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | STEPHANIE SMITH Owner 770-883-3253 |
| Organization Subpart ? | No |
| Primary Taxonomy | 208D00000X General Practice |
| Additional Taxonomies | 363LP2300X Nurse Practitioner, Primary Care |
| Enumeration Date | 2025-02-21 |
| Last Update Date | 2025-03-25 |