| NPI | 1851695647 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | JULIE MICHELE CRUSOR Owner 770-901-9303 |
| Organization Subpart ? | No |
| Primary Taxonomy | 207Q00000X Family Medicine (Licence: GA 060820) |
| Additional Taxonomies | 111NR0400X Chiropractor, Rehabilitation (Licence: GA 6027) |
| Enumeration Date | 2011-01-07 |
| Last Update Date | 2011-01-07 |