EMPOWER FAMILY MEDICINE MEMBER AGREEMENTGeorgia • October 26th, 2015
Jurisdiction FiledOctober 26th, 2015This 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).