| NPI | 1982966008 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | MICHAEL KLEIN Member 678-471-0255 |
| Organization Subpart ? | No |
| Primary Taxonomy | 208D00000X General Practice |
| Additional Taxonomies | 111N00000X Chiropractor |
| 363L00000X Nurse Practitioner | |
| Enumeration Date | 2012-06-14 |
| Last Update Date | 2012-08-16 |