NPI age
19 years
Enumerated 2006-09-20
Across 730 active clinic/center providers in Georgia.
4 individual providers on file at this primary practice address.
| Type | Value | Notes |
|---|---|---|
| 05 (GA) | 0008141736C | |
| 01 | 1151048 | NCPDP |
Multi-provider organization. 4 individual providers on file at this primary address.
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