| NPI | 1013234541 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | TAMMY J BRICKLE Billing Agent 478-254-5943 |
| Organization Subpart ? | No |
| Primary Taxonomy | 207P00000X Emergency Medicine (Licence: GA 011990) |
| Enumeration Date | 2010-04-23 |
| Last Update Date | 2010-12-20 |