| NPI | 1912554569 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | NITI SHAH Director 770-927-7424 |
| Organization Subpart ? | No |
| Primary Taxonomy | 261QM1300X Clinic/Center, Multi-Specialty |
| Additional Taxonomies | 235Z00000X Speech-Language Pathologist, |
| Enumeration Date | 2019-08-19 |
| Last Update Date | 2024-09-16 |