| NPI | 1912315003 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | SCOTT WARNER Manager 770-889-4800 |
| Organization Subpart ? | No |
| Primary Taxonomy | 208D00000X General Practice |
| Additional Taxonomies | 111N00000X Chiropractor |
| 363L00000X Nurse Practitioner | |
| Enumeration Date | 2014-08-01 |
| Last Update Date | 2014-08-01 |