| NPI | 1174705073 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | SANDRA KAE BOHNSTENGEL Physician 912-354-4044 |
| Organization Subpart ? | No |
| Primary Taxonomy | 208D00000X General Practice (Licence: GA 038692) |
| Enumeration Date | 2007-12-03 |
| Last Update Date | 2017-05-17 |