NPI | 1043620966 |
---|---|
Entity Type | Organization |
Authorized Contact | ALTHEIA WARE Owner/Provider 706-315-0836 |
Organization Subpart ? | No |
Primary Taxonomy | 363LF0000X Nurse Practitioner, Family (Licence: GA RN142278) |
Additional Taxonomies | 363LF0000X Nurse Practitioner, Family (Licence: GA RN190791) |
Enumeration Date | 2014-04-30 |
Last Update Date | 2016-08-18 |