| NPI | 1144593146 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | MARK HARRIS ANTHONY President 706-714-4402 |
| Organization Subpart ? | No |
| Primary Taxonomy | 261QM2500X Clinic/Center Medical Specialty (Licence: GA 1547) |
| Enumeration Date | 2012-02-22 |
| Last Update Date | 2012-02-22 |