| NPI | 1336408608 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | GEORGE PAUL TKALYCH Medical Doctor / President 706-546-1327 |
| Organization Subpart ? | No |
| Primary Taxonomy | 207Y00000X Otolaryngology (Licence: GA 022480) |
| Enumeration Date | 2012-05-08 |
| Last Update Date | 2012-05-08 |