| NPI | 1386180206 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | CONCHETTA S PERRY Owner/Nurse Practitioner 706-641-2151 |
| Organization Subpart ? | No |
| Primary Taxonomy | 363LF0000X Nurse Practitioner, Family (Licence: GA RN212280) |
| Enumeration Date | 2017-01-17 |
| Last Update Date | 2017-01-17 |