| NPI | 1124331970 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | JONATHAN PAUL CONNELL President 229-903-0022 |
| Organization Subpart ? | No |
| Primary Taxonomy | 1835P1200X Pharmacist, Pharmacotherapy (Licence: GA PHOP000026) |
| Additional Taxonomies | 2084A0401X Psychiatry & Neurology, Addiction Medicine (Licence: GA NTP001025) |
| Enumeration Date | 2010-07-22 |
| Last Update Date | 2010-07-22 |