| NPI | 1407373210 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | MAURICE SKILLERN President / CEO 706-536-3272 |
| Organization Subpart ? | No |
| Primary Taxonomy | 363A00000X Physician Assistant (Licence: TN 1805) |
| Enumeration Date | 2017-08-23 |
| Last Update Date | 2021-11-10 |