| NPI | 1922236413 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | ROBERT SAKULANDA Director 678-615-2082 |
| Organization Subpart ? | No |
| Primary Taxonomy | 261QP2300X Clinic/Center, Primary Care (Licence: GA 061649) |
| Enumeration Date | 2009-06-23 |
| Last Update Date | 2009-06-23 |