| 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 |