| NPI | 1134316920 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | RAYMOND DERRY CROSBY CEO 229-247-2482 |
| Organization Subpart ? | No |
| Primary Taxonomy | 261QM2500X Clinic/Center, Medical Specialty (Licence: GA 29316) |
| Enumeration Date | 2007-09-26 |
| Last Update Date | 2010-08-05 |