| NPI | 1669590725 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | PANETTA BROWN Office Manager 478-741-5155 |
| Organization Subpart ? | No |
| Primary Taxonomy | 174400000X Specialist (Licence: GA 024808) |
| Additional Taxonomies | 174400000X Specialist (Licence: GA 056574) |
| Enumeration Date | 2007-03-27 |
| Last Update Date | 2020-08-22 |