| NPI | 1174961809 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | ROBERT LAMBERTS Physician 706-504-9321 |
| Organization Subpart ? | No |
| Primary Taxonomy | 332900000X Non-Pharmacy Dispensing Site (Licence: GA 038834) |
| Enumeration Date | 2013-06-04 |
| Last Update Date | 2013-06-04 |