| NPI | 1851126130 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | MELISSA LONG Owner/CEO 470-273-1699 |
| Organization Subpart ? | No |
| Primary Taxonomy | 208000000X Pediatrics |
| Additional Taxonomies | 363LP0200X Nurse Practitioner, Pediatrics |
| Enumeration Date | 2024-09-05 |
| Last Update Date | 2024-09-05 |