| NPI | 1255702940 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | ANNE M LOEBL Owner 706-447-3909 |
| Organization Subpart ? | No |
| Primary Taxonomy | 261QM2500X Clinic/Center, Medical Specialty (Licence: GA 022436) |
| Enumeration Date | 2015-10-07 |
| Last Update Date | 2015-10-07 |