| NPI | 1699151571 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | DON WRIGHT Member 706-614-0828 |
| Organization Subpart ? | No |
| Primary Taxonomy | 261QH0100X Clinic/Center, Health Services (Licence: GA Com2015-00500) |
| Enumeration Date | 2015-08-03 |
| Last Update Date | 2015-08-10 |