| NPI | 1457849457 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | BETHANY C WHITENER Owner 706-455-1478 |
| Organization Subpart ? | No |
| Primary Taxonomy | 261QP2300X Clinic/Center Primary Care (Licence: TN 24080) |
| Additional Taxonomies | 207R00000X Internal Medicine (Licence: TN 2341) |
| Enumeration Date | 2018-04-25 |
| Last Update Date | 2022-11-30 |