| NPI | 1861788986 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | DALE ADRIAN CAREY Co Owner 678-705-1733 |
| Organization Subpart ? | No |
| Primary Taxonomy | 207Q00000X Family Medicine |
| Additional Taxonomies | 261QM1300X Clinic/Center, Multi-Specialty (Licence: GA 026238) |
| Enumeration Date | 2011-06-27 |
| Last Update Date | 2015-10-26 |