| NPI | 1629203294 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | JOANNE S JOHANSEN C.O.O. 912-354-7676 |
| Organization Subpart ? | No |
| Primary Taxonomy | 2084N0400X Psychiatry & Neurology, Neurology (Licence: GA 028560) |
| Enumeration Date | 2009-05-26 |
| Last Update Date | 2013-03-08 |