NPI age
18 years
Enumerated 2007-09-24
Across 2449 active community/behavioral health providers in Georgia.
| Type | Value | Notes |
|---|---|---|
| 01 (GA) | GRP1997 | MEDICARE PROVIDER NUMBER |
| 01 (GA) | 55002141A | MEDICARE CROSS OVER |
Single-site organization. Only one practice location on file.
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