NPI | 1275710998 |
---|---|
Entity Type | Organization |
Authorized Contact | SHANNON E COX Office Manager 706-359-2419 |
Organization Subpart ? | No |
Primary Taxonomy | 305R00000X Preferred Provider Organization (Licence: GA 046168) |
Enumeration Date | 2008-01-24 |
Last Update Date | 2008-01-24 |