| NPI | 1942922190 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | TEEISA RICHARDSON CEO 678-774-9156 |
| Organization Subpart ? | No |
| Primary Taxonomy | 202D00000X Integrative Medicine |
| Additional Taxonomies | 261QP2300X Clinic/Center, Primary Care |
| Enumeration Date | 2022-09-14 |
| Last Update Date | 2024-10-09 |