| NPI | 1851152458 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | SHELLEY ANDERSON CEO 678-823-5699 |
| Organization Subpart ? | No |
| Primary Taxonomy | 261Q00000X Clinic/Center |
| Additional Taxonomies | 363A00000X Physician Assistant |
| Enumeration Date | 2024-01-19 |
| Last Update Date | 2024-01-19 |