| NPI | 1932808094 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | SHANTRICE NICHOLS-BATES Co Owner/ Medical Director 470-278-2618 |
| Organization Subpart ? | No |
| Primary Taxonomy | 363LF0000X Nurse Practitioner, Family |
| Additional Taxonomies | 261QP2300X Clinic/Center, Primary Care |
| Enumeration Date | 2023-02-27 |
| Last Update Date | 2025-01-16 |