| NPI | 1871394841 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | CHARLIE ROUSE Co President 678-621-4715 |
| Organization Subpart ? | No |
| Primary Taxonomy | 207Q00000X Family Medicine |
| Additional Taxonomies | 363AM0700X Physician Assistant, Medical |
| 363LP2300X Nurse Practitioner, Primary Care | |
| Enumeration Date | 2025-03-24 |
| Last Update Date | 2025-03-24 |