| NPI | 1225812571 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | MELISSA BROSKE JACOME Nurse Practitioner 706-294-6485 |
| Organization Subpart ? | No |
| Primary Taxonomy | 207Q00000X Family Medicine |
| Additional Taxonomies | 133NN1002X Nutritionist, Nutrition, Education |
| 207QB0002X Family Medicine, Bariatric Medicine | |
| 2083B0002X Preventive Medicine, Obesity Medicine | |
| 261QH0100X Clinic/Center, Health Services | |
| 261QI0500X Clinic/Center, Infusion Therapy | |
| 305S00000X Point of Service | |
| 363A00000X Physician Assistant | |
| 363L00000X Nurse Practitioner | |
| Enumeration Date | 2023-08-18 |
| Last Update Date | 2024-01-19 |