| NPI | 1063649903 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | STEVEN F KING CFO 478-289-1376 |
| Organization Subpart ? | No |
| Primary Taxonomy | 261QR1300X Clinic/Center Rural Health |
| Additional Taxonomies | 261Q00000X Clinic/Center |
| Enumeration Date | 2009-06-18 |
| Last Update Date | 2014-01-31 |