| NPI | 1134516164 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | MARTINA NICOLE BRYANT Lpn 912-651-3378 |
| Organization Subpart ? | No |
| Primary Taxonomy | 261QP0905X Clinic/Center, Public Health, State or Local (Licence: GA LPN086855) |
| Enumeration Date | 2015-04-16 |
| Last Update Date | 2015-04-16 |