NPI age
16 years
Enumerated 2009-07-15
Across 205 active clinic/center providers in Georgia.
1 secondary location on file with NPPES.
| Type | Value | Notes |
|---|---|---|
| 05 (GA) | 512260511A | |
| 05 (GA) | 003112349B |
Multi-site organization. 1 additional practice location on file.
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