| NPI | 1215419411 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | BEVERLY REYNOLDS Office Manager 706-322-1486 |
| Organization Subpart ? | No |
| Primary Taxonomy | 207RN0300X Internal Medicine Nephrology |
| Additional Taxonomies | 363LF0000X Nurse Practitioner Family |
| Enumeration Date | 2018-09-04 |
| Last Update Date | 2024-03-06 |