| NPI | 1699110437 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | CHARLES BAILEY PHILLIPS President 478-475-4131 |
| Organization Subpart ? | No |
| Primary Taxonomy | 261QM2500X Clinic/Center, Medical Specialty (Licence: GA 006566) |
| Enumeration Date | 2013-05-07 |
| Last Update Date | 2013-05-07 |