| NPI | 1073723680 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | CONRAD N. MILLER President 478-745-7878 |
| Organization Subpart ? | No |
| Primary Taxonomy | 207Q00000X Family Medicine (Licence: GA 040962) |
| Additional Taxonomies | 208D00000X General Practice (Licence: GA GA 040963) |
| Enumeration Date | 2007-05-23 |
| Last Update Date | 2023-03-07 |