| NPI | 1295992022 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | MANDY LYNN FONTAINE Office Manager 706-695-1488 |
| Organization Subpart ? | No |
| Primary Taxonomy | 207R00000X Internal Medicine (Licence: GA 035479) |
| Enumeration Date | 2008-05-20 |
| Last Update Date | 2008-05-20 |