| NPI | 1922870047 |
|---|---|
| Doing Business As | FLAMINGO MOJO |
| Entity Type | Organization |
| Authorized Contact | LORI HUDSON Owner 678-761-9479 |
| Organization Subpart ? | No |
| Primary Taxonomy | 363LF0000X Nurse Practitioner, Family |
| Enumeration Date | 2023-10-23 |
| Last Update Date | 2023-10-23 |