| NPI | 1164882635 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | RAMONA BURNSIDE Office Mgr. 706-350-5525 |
| Organization Subpart ? | No |
| Primary Taxonomy | 2084N0400X Psychiatry & Neurology, Neurology (Licence: GA 58107) |
| Enumeration Date | 2016-02-26 |
| Last Update Date | 2018-08-14 |