| NPI | 1245419183 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | RODNEY DONALD TYSON President 229-896-3424 |
| Organization Subpart ? | No |
| Primary Taxonomy | 261QP2300X Clinic/Center, Primary Care (Licence: GA 038994) |
| Enumeration Date | 2007-10-28 |
| Last Update Date | 2010-01-04 |