NPI | 1356521595 |
---|---|
Entity Type | Organization |
Authorized Contact | DENYSE PIERCE Practice Administrator 229-242-3002 |
Organization Subpart ? | No |
Primary Taxonomy | 261QM2500X Clinic/Center, Medical Specialty |
Enumeration Date | 2007-11-05 |
Last Update Date | 2007-11-05 |