NPI age
21 years
Enumerated 2005-05-23
Across 602 active clinic/center providers in Georgia.
20 individual providers on file at this primary practice address.
| Type | Value | Notes |
|---|---|---|
| 05 (GA) | 000890667A | |
| 01 (GA) | P00164715 | RR MEDICARE |
| 01 | 490004881 | RR MEDICARE |
Doing-business-as, former, and alternate names recorded by NPPES.
Multi-provider organization. 20 individual providers on file at this primary address.
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