| NPI | 1376983262 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | WILLIAM A DIX Secretary 706-549-0901 |
| Organization Subpart ? | No |
| Primary Taxonomy | 2083P0011X Preventive Medicine, Undersea and Hyperbaric Medicine (Licence: GA 35243) |
| Enumeration Date | 2013-06-25 |
| Last Update Date | 2019-09-24 |