| NPI | 1447461488 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | JEANNIE M BATTEN Office Manager 912-264-9118 |
| Organization Subpart ? | No |
| Primary Taxonomy | 174400000X Specialist (Licence: GA 038105) |
| Additional Taxonomies | 174400000X Specialist (Licence: GA 051407) |
| Enumeration Date | 2007-05-24 |
| Last Update Date | 2020-08-22 |