NPI age
16 years
Enumerated 2009-06-30
Across 655 active clinic/center providers in Georgia.
| Type | Value | Notes |
|---|---|---|
| 01 (GA) | 134759118 | MEDICAID REFERENCE NUMBER |
| 05 (GA) | 971545216B | |
| 01 (GA) | 1386802155 | NPI 1386802155 |
Single-site organization. Only one practice location on file.
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