| NPI | 1336479849 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | PAULA KREISSLER President 912-998-0040 |
| Organization Subpart ? | No |
| Primary Taxonomy | 261QM2500X Clinic/Center Medical Specialty (Licence: GA 3118839999) |
| Enumeration Date | 2010-01-05 |
| Last Update Date | 2010-01-05 |