| NPI | 1942663513 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | SOREN S THOMAS Owner 404-391-9953 |
| Organization Subpart ? | No |
| Primary Taxonomy | 261QP2300X Clinic/Center, Primary Care (Licence: GA GA026895) |
| Enumeration Date | 2016-04-01 |
| Last Update Date | 2016-04-01 |