| NPI | 1255828828 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | SAMUEL TED RICE Owner/Md 706-323-0990 |
| Organization Subpart ? | No |
| Primary Taxonomy | 363LF0000X Nurse Practitioner, Family (Licence: GA RN224459) |
| Enumeration Date | 2018-04-18 |
| Last Update Date | 2018-04-18 |