| NPI | 1104936939 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | SUSAN BEACHAM Nurse Manager, Primary Care 478-272-1210 |
| Organization Subpart ? | No |
| Primary Taxonomy | 261QV0200X Clinic/Center, VA (Licence: GA RN069362) |
| Enumeration Date | 2006-08-30 |
| Last Update Date | 2020-08-22 |