| NPI | 1568784544 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | JACQUELINE E RICE Billing Manager 912-356-1747 |
| Organization Subpart ? | No |
| Primary Taxonomy | 261QP2300X Clinic/Center, Primary Care (Licence: GA 031985) |
| Enumeration Date | 2010-02-18 |
| Last Update Date | 2010-02-18 |