NPI | 1689859720 |
---|---|
Entity Type | Organization |
Authorized Contact | CHAROLETT MITTIE ENGRAM Practice Administrator 229-387-9205 |
Organization Subpart ? | No |
Primary Taxonomy | 207Q00000X Family Medicine (Licence: GA 049713) |
Enumeration Date | 2008-01-08 |
Last Update Date | 2008-01-08 |