| NPI | 1912922675 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | LINDA TROTTER Clinic Administrator 404-691-1106 |
| Organization Subpart ? | No |
| Primary Taxonomy | 174400000X Specialist (Licence: GA PT003217) |
| Enumeration Date | 2006-07-13 |
| Last Update Date | 2020-08-22 |