NPI | 1275002636 |
---|---|
Doing Business As | PHC OF GA COLLEGE PARK |
Entity Type | Organization |
Authorized Contact | DAVID A. CULVER Administrator 904-825-4368 |
Organization Subpart ? | No |
Primary Taxonomy | 207QG0300X Family Medicine, Geriatric Medicine |
Enumeration Date | 2018-11-15 |
Last Update Date | 2018-11-15 |