NPI age
12 years
Enumerated 2013-07-29
Across 563 active clinic/center providers in Georgia.
3 individual providers on file at this primary practice address.
| Type | Value | Notes |
|---|---|---|
| 05 (GA) | 003146123A | |
| 01 (GA) | 11D2066342 | CLIA WAIVER |
Doing-business-as, former, and alternate names recorded by NPPES.
Multi-provider organization. 3 individual providers on file at this primary address.
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