| NPI | 1982033411 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | JAYASRI MALLAVARAPU CEO 678-455-2295 |
| Organization Subpart ? | No |
| Primary Taxonomy | 261QP2300X Clinic/Center, Primary Care (Licence: GA 061288) |
| Enumeration Date | 2013-11-05 |
| Last Update Date | 2014-03-25 |