| NPI | 1629428446 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | BEURENA JOHNSON President 706-691-8815 |
| Organization Subpart ? | No |
| Primary Taxonomy | 1744P3200X Specialist, Prosthetics Case Management (Licence: GA CO059153) |
| Enumeration Date | 2016-06-14 |
| Last Update Date | 2016-06-14 |