| NPI | 1205207933 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | GERALD WILLIAM WIECZOREK Business Manager 706-327-4880 |
| Organization Subpart ? | No |
| Primary Taxonomy | 261QM1000X Clinic/Center, Migrant Health (Licence: GA RN042301) |
| Enumeration Date | 2015-10-07 |
| Last Update Date | 2015-10-07 |