| NPI | 1962740001 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | TYRONE C MALLOY Owner 404-892-3239 |
| Organization Subpart ? | No |
| Primary Taxonomy | 261QA0005X Clinic/Center, Ambulatory Family Planning Facility (Licence: GA 23086) |
| Additional Taxonomies | 261Q00000X Clinic/Center (Licence: GA 23086) |
| Enumeration Date | 2013-01-24 |
| Last Update Date | 2013-01-24 |