NPI age
8 years
Enumerated 2017-10-20
Across 250 active specialist providers in Georgia.
| Type | Value | Notes |
|---|---|---|
| 01 (GA) | 1744P3200X | 1744P3200X |
Solo or small practice. No other active providers share this practice address in NPPES. This provider is listed as a sole proprietor.
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