| NPI | 1063872372 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | HETAL THAKORE Owner 706-267-7681 |
| Organization Subpart ? | No |
| Primary Taxonomy | 207R00000X Internal Medicine |
| Additional Taxonomies | 207Q00000X Family Medicine |
| Enumeration Date | 2016-02-29 |
| Last Update Date | 2016-02-29 |