| NPI | 1073885828 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | STANLEY SETH BUSH Proprietor 478-741-7371 |
| Organization Subpart ? | No |
| Primary Taxonomy | 2080A0000X Pediatrics, Adolescent Medicine (Licence: GA 048846) |
| Enumeration Date | 2012-02-08 |
| Last Update Date | 2012-02-08 |