| NPI | 1285810366 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | KELLY M DIRTING Billing Mgr 912-262-9289 |
| Organization Subpart ? | No |
| Primary Taxonomy | 207K00000X Allergy & Immunology (Licence: GA GA023506) |
| Enumeration Date | 2008-01-18 |
| Last Update Date | 2021-11-29 |