| NPI | 1164685343 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | SHIRLEY ANN TAYLOR Certified Medical Office Manager 706-922-5864 |
| Organization Subpart ? | Yes |
| Primary Taxonomy | 174400000X Specialist (Licence: GA 030584) |
| Enumeration Date | 2008-07-08 |
| Last Update Date | 2012-06-26 |