| NPI | 1497480990 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | BOBBY STONE Director 912-685-7533 |
| Organization Subpart ? | No |
| Primary Taxonomy | 261Q00000X Clinic/Center |
| Additional Taxonomies | 261QM1300X Clinic/Center, Multi-Specialty |
| Enumeration Date | 2022-07-19 |
| Last Update Date | 2022-07-27 |