| NPI | 1104282243 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | RONALD COLE Owner/Office Manager 706-495-3573 |
| Organization Subpart ? | No |
| Primary Taxonomy | 363LF0000X Nurse Practitioner, Family (Licence: TX AP125932) |
| Enumeration Date | 2016-01-05 |
| Last Update Date | 2016-01-05 |