NPI age
21 years
Enumerated 2005-05-23
Across 30 active clinic/center providers in Georgia.
5 individual providers on file at this primary practice address.
| Type | Value | Notes |
|---|---|---|
| 01 | 52070692 | BCBS PROVIDER # |
| 01 (GA) | 7487068 | AETNA PROVIDER # |
| 05 (SC) | SL0069 |
Doing-business-as, former, and alternate names recorded by NPPES.
Multi-provider organization. 5 individual providers on file at this primary address.
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