| NPI | 1013661834 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | CONRAD MILLER Owner 478-745-7878 |
| Organization Subpart ? | No |
| Primary Taxonomy | 207Q00000X Family Medicine |
| Additional Taxonomies | 1744R1102X Specialist, Research Study |
| Enumeration Date | 2022-02-10 |
| Last Update Date | 2022-02-10 |