| NPI | 1528401056 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | MARION ELAINE KENNEDY Treasurer/Secretary 912-634-2651 |
| Organization Subpart ? | No |
| Primary Taxonomy | 207Q00000X Family Medicine (Licence: GA 050645) |
| Enumeration Date | 2013-04-15 |
| Last Update Date | 2013-08-05 |