NPI age
19 years
Enumerated 2007-03-06
Across 318 active clinic/center providers in Georgia.
| Type | Value | Notes |
|---|---|---|
| 05 (GA) | 871643718A | |
| 05 (TN) | 871643718A | |
| 05 (GA) | FA1875624 |
Single-site organization. Only one practice location on file.
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