| NPI | 1619150745 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | WALLACE S. PHILLIPS Paractice Manager 706-549-2700 |
| Organization Subpart ? | No |
| Primary Taxonomy | 367500000X Nurse Anesthetist, Certified Registered |
| Enumeration Date | 2007-12-12 |
| Last Update Date | 2007-12-12 |