| NPI | 1649789132 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | KAREN C CHUMLEY Financial Manager 912-303-6678 |
| Organization Subpart ? | No |
| Primary Taxonomy | 363AS0400X Physician Assistant, Surgical (Licence: GA 149391) |
| Enumeration Date | 2017-09-27 |
| Last Update Date | 2017-09-27 |