NPI age
17 years
Enumerated 2009-02-02
Across 205 active clinic/center providers in Georgia.
| Type | Value | Notes |
|---|---|---|
| 05 (GA) | 342515362A | |
| 05 (GA) | 849865610-A |
Single-site organization. Only one practice location on file.
Subpart of Santa Rosa Clinic, PA.
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