NPI age
12 years
Enumerated 2013-07-23
Across 563 active clinic/center providers in Georgia.
| Type | Value | Notes |
|---|---|---|
| 01 (GA) | 11D2068046 | CLIA |
| 05 (GA) | 003140980A |
Doing-business-as, former, and alternate names recorded by NPPES.
Single-site organization. Only one practice location on file.
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