| NPI | 1922118595 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | ANDREA L SELLS Office Manager 678-990-4828 |
| Organization Subpart ? | No |
| Primary Taxonomy | 261Q00000X Clinic/Center (Licence: GA BL0600486) |
| Enumeration Date | 2006-08-30 |
| Last Update Date | 2012-06-19 |