| NPI | 1841507621 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | DIANE ROBERTS President 770-879-0064 |
| Organization Subpart ? | No |
| Primary Taxonomy | 207Q00000X Family Medicine (Licence: GA 33908) |
| Additional Taxonomies | 207Q00000X Family Medicine (Licence: AL DO.1081) |
| 207Q00000X Family Medicine (Licence: TN 2082) | |
| 208VP0000X Pain Medicine, Pain Medicine (Licence: GA 33908) | |
| Enumeration Date | 2010-09-01 |
| Last Update Date | 2010-09-01 |