| NPI | 1114740362 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | JULIE HODGES Controller 229-259-4140 |
| Organization Subpart ? | No |
| Primary Taxonomy | 261QM1300X Clinic/Center, Multi-Specialty |
| Additional Taxonomies | 261QU0200X Clinic/Center, Urgent Care |
| Enumeration Date | 2024-11-06 |
| Last Update Date | 2025-03-28 |