| NPI | 1568206217 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | TROY FULTON CEO 229-220-5628 |
| Organization Subpart ? | No |
| Primary Taxonomy | 261QM1300X Clinic/Center, Multi-Specialty |
| Additional Taxonomies | 101Y00000X Counselor |
| 163W00000X Registered Nurse | |
| 171400000X Health & Wellness Coach | |
| 247000000X Technician, Health Information | |
| 363L00000X Nurse Practitioner | |
| 390200000X Student in an Organized Health Care Education/Training Program | |
| Enumeration Date | 2024-06-19 |
| Last Update Date | 2024-06-19 |