| NPI | 1841736303 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | ANGELA S PIRTLE Billing Manager 770-755-9137 |
| Organization Subpart ? | No |
| Primary Taxonomy | 208D00000X General Practice (Licence: GA 1831215714) |
| Additional Taxonomies | 111N00000X Chiropractor (Licence: GA CHIRO08008) |
| Enumeration Date | 2017-01-09 |
| Last Update Date | 2017-01-09 |