NPI age
20 years
Enumerated 2006-05-26
Across 563 active clinic/center providers in Georgia.
| Type | Value | Notes |
|---|---|---|
| 01 (GA) | 11D1049749 | CLIA CERTIFICATE OF WAIVE |
| 05 (GA) | 230307270A |
Doing-business-as, former, and alternate names recorded by NPPES.
Single-site organization. Only one practice location on file.
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