| NPI | 1619567526 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | AMBER MCCRAY Medical Assistant 706-403-2806 |
| Organization Subpart ? | No |
| Primary Taxonomy | 332B00000X Durable Medical Equipment & Medical Supplies |
| Additional Taxonomies | 174400000X Specialist |
| Enumeration Date | 2021-01-25 |
| Last Update Date | 2021-05-18 |