| NPI | 1538144480 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | GLENDA K HALL Business Office Manager 706-722-4245 |
| Organization Subpart ? | No |
| Primary Taxonomy | 174400000X Specialist (Licence: GA 46944) |
| Additional Taxonomies | 174400000X Specialist (Licence: GA 16487) |
| Enumeration Date | 2005-12-14 |
| Last Update Date | 2020-08-22 |