| NPI | 1639334600 |
|---|---|
| Doing Business As | NISSAN HEALTH AND WELLNESS CENTER |
| Entity Type | Organization |
| Authorized Contact | STUART CLARK Executive VP 706-760-0700 |
| Organization Subpart ? | No |
| Primary Taxonomy | 208D00000X General Practice |
| Enumeration Date | 2008-07-18 |
| Last Update Date | 2008-07-18 |