NPI age
13 years
Enumerated 2013-02-21
Across 563 active clinic/center providers in Georgia.
1 individual provider on file at this primary practice address.
| Type | Value | Notes |
|---|---|---|
| 01 (GA) | 11D2056132 | CLIA |
| 01 (GA) | ESRD000703 | ESRD PERMIT |
Doing-business-as, former, and alternate names recorded by NPPES.
Multi-provider organization. 1 individual provider on file at this primary address.
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