NPI age
11 years
Enumerated 2014-07-31
Across 563 active clinic/center providers in Georgia.
| Type | Value | Notes |
|---|---|---|
| 05 (GA) | 003155382A | |
| 01 (GA) | 11D2081984 | CLIA |
Doing-business-as, former, and alternate names recorded by NPPES.
Single-site organization. Only one practice location on file.
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