NPI | 1043965056 |
---|---|
Entity Type | Organization |
Authorized Contact | AMY BUFFINGTON Credentialing Director 706-620-4494 |
Organization Subpart ? | No |
Primary Taxonomy | 261QF0400X Clinic/Center Federally Qualified Health Center (FQHC) |
Enumeration Date | 2022-02-17 |
Last Update Date | 2022-02-17 |