| NPI | 1619442829 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | LANIE WELCH Owner 912-245-1145 |
| Organization Subpart ? | No |
| Primary Taxonomy | 207Q00000X Family Medicine |
| Additional Taxonomies | 261QU0200X Clinic/Center, Urgent Care |
| Enumeration Date | 2018-10-04 |
| Last Update Date | 2022-10-24 |