| NPI | 1316295538 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | LORETTA FITZPATRICK Consultant 770-943-5260 |
| Organization Subpart ? | No |
| Primary Taxonomy | 261QR1300X Clinic/Center, Rural Health (Licence: LA 002493) |
| Enumeration Date | 2012-08-20 |
| Last Update Date | 2013-04-11 |