| NPI | 1962660555 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | DANIELLE DENISE GREENE President 404-758-0770 |
| Organization Subpart ? | No |
| Primary Taxonomy | 305R00000X Preferred Provider Organization (Licence: GA 011973) |
| Enumeration Date | 2008-05-30 |
| Last Update Date | 2008-05-30 |