| NPI | 1700058682 |
|---|---|
| Other Name | JOHAGSTON |
| Entity Type | Organization |
| Authorized Contact | KATHERINE ANNE KEISTER Clinical Staff Manager 912-356-1095 |
| Organization Subpart ? | No |
| Primary Taxonomy | 251S00000X (Licence: GA LPC005603) |
| Enumeration Date | 2008-03-31 |
| Last Update Date | 2011-06-14 |