| NPI | 1982011359 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | RAVINDER MANCHIREDDY CEO 678-205-1959 |
| Organization Subpart ? | No |
| Primary Taxonomy | 363LF0000X Nurse Practitioner, Family (Licence: GA RN171690) |
| Enumeration Date | 2014-07-17 |
| Last Update Date | 2014-07-17 |