NPI age
12 years
Enumerated 2014-05-08
Across 661 active general practice providers in Georgia.
1 secondary location on file with NPPES.
| Type | Value | Notes |
|---|---|---|
| 01 | 1891106183 | NPI |
Solo or small practice. No other active providers share this practice address in NPPES. This provider is listed as a sole proprietor.
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