NPI age
14 years
Enumerated 2011-12-01
Across 602 active clinic/center providers in Georgia.
1 individual provider on file at this primary practice address.
| Type | Value | Notes |
|---|---|---|
| 01 | GRP4317 | PROVIDER TRANSACTION ACCESS NUMBER |
| 05 (GA) | 000624896A |
Multi-provider organization. 1 individual provider on file at this primary address.
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