| NPI | 1265972558 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | TERRI A COOK Practice Manager 706-868-1906 |
| Organization Subpart ? | No |
| Primary Taxonomy | 363LF0000X Nurse Practitioner, Family (Licence: GA RN207064) |
| Enumeration Date | 2017-03-06 |
| Last Update Date | 2017-03-06 |