| NPI | 1861136483 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | BRITTANY WILSON Owner 470-697-1396 |
| Organization Subpart ? | No |
| Primary Taxonomy | 208000000X Pediatrics |
| Additional Taxonomies | 261QP2300X Clinic/Center, Primary Care |
| Enumeration Date | 2022-04-21 |
| Last Update Date | 2022-09-09 |