EMPOWER FAMILY MEDICINE MEMBER AGREEMENTMember Agreement • October 26th, 2015 • Georgia
Contract Type FiledOctober 26th, 2015 JurisdictionThis is an Agreement between Empower Family Medicine, L.L.C., a Georgia professional corporation, located at 209A Swanton Way Suite 101, Decatur, GA 30030, and you, (Principal Member). Melissa Black M.D. (Physician) serves in the capacity as an agent of Empower Family Medicine (EFM).