| NPI | 1992301402 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | BENJAMIN MITCHELL Owner 770-614-4060 |
| Organization Subpart ? | No |
| Primary Taxonomy | 207QA0505X Family Medicine, Adult Medicine |
| Additional Taxonomies | 208D00000X General Practice |
| Enumeration Date | 2020-12-09 |
| Last Update Date | 2021-02-19 |