| NPI | 1437363751 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | CAROLE BRIDGES Secretary 706-278-4640 |
| Organization Subpart ? | No |
| Primary Taxonomy | 261QM2500X Clinic/Center Medical Specialty (Licence: GA 012695) |
| Enumeration Date | 2007-05-09 |
| Last Update Date | 2020-08-22 |