| NPI | 1962560649 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | BRIAN BONNER Manager 770-475-8221 |
| Organization Subpart ? | No |
| Primary Taxonomy | 302R00000X Health Maintenance Organization (Licence: GA 621111) |
| Enumeration Date | 2006-12-05 |
| Last Update Date | 2007-10-26 |