| NPI | 1578766671 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | NAN H. ANDERSON Office Manager 478-934-4763 |
| Organization Subpart ? | No |
| Primary Taxonomy | 1223G0001X Dentist, General Practice (Licence: GA 9790) |
| Additional Taxonomies | 363LA2200X Nurse Practitioner, Adult Health (Licence: GA RN126365 NP) |
| 364S00000X Clinical Nurse Specialist (Licence: GA RN052713) | |
| Enumeration Date | 2007-06-06 |
| Last Update Date | 2020-08-22 |