| NPI | 1659312452 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | CHRISTINE A KREIDE President 912-965-9605 |
| Organization Subpart ? | No |
| Primary Taxonomy | 261Q00000X Clinic/Center (Licence: GA OPT1194) |
| Additional Taxonomies | 332B00000X Durable Medical Equipment & Medical Supplies (Licence: GA OPT1194T) |
| Enumeration Date | 2006-06-10 |
| Last Update Date | 2008-03-19 |