| NPI | 1093154700 |
|---|---|
| Doing Business As | WILLISTON FAMILY PRACTICE |
| Entity Type | Organization |
| Authorized Contact | PHILIP H EASTMAN President 770-904-6731 |
| Organization Subpart ? | No |
| Primary Taxonomy | 261Q00000X (Licence: SC HTL0485) |
| Enumeration Date | 2013-06-17 |
| Last Update Date | 2013-06-17 |