| NPI | 1588028591 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | EBONY HILLMON SCRUGGS Owner/Provider 229-474-4101 |
| Organization Subpart ? | No |
| Primary Taxonomy | 261QH0100X Clinic/Center Health Service (Licence: GA RN054469) |
| Enumeration Date | 2016-04-06 |
| Last Update Date | 2024-04-30 |