| NPI | 1699924829 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | SHERRI LYNETTE MOSLEY Authorized Representative 706-323-1873 |
| Organization Subpart ? | No |
| Primary Taxonomy | 261QH0100X Clinic/Center Health Service (Licence: GA CHIR008246) |
| Enumeration Date | 2008-09-11 |
| Last Update Date | 2008-09-11 |