| NPI | 1831422567 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | ATLEE WAMPLER President 770-392-9299 |
| Organization Subpart ? | No |
| Primary Taxonomy | 207RS0010X Internal Medicine Sports Medicine (Licence: GA 038955) |
| Additional Taxonomies | 332BC3200X Durable Medical Equipment & Medical Supplies Customized Equipment (Licence: GA 038955) |
| Enumeration Date | 2009-09-14 |
| Last Update Date | 2013-02-18 |