| NPI | 1982887543 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | STEFAN CHARLES G SABOURA Owner/ Provider 678-567-2313 |
| Organization Subpart ? | No |
| Primary Taxonomy | 111NR0400X Chiropractor, Rehabilitation (Licence: GA CHIR006384) |
| Additional Taxonomies | 207Q00000X Family Medicine (Licence: GA 39009) |
| 2083P0500X Preventive Medicine, Preventive Medicine/Occupational Environmental Medicine (Licence: GA 68404) | |
| 363LP2300X Nurse Practitioner, Primary Care (Licence: GA RN191854) | |
| Enumeration Date | 2007-12-06 |
| Last Update Date | 2023-12-13 |