| NPI | 1700119997 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | OSARETIN DANIEL OKUNGBOWA Owner 912-225-1836 |
| Organization Subpart ? | No |
| Primary Taxonomy | 207Q00000X Family Medicine (Licence: GA 062926) |
| Enumeration Date | 2009-09-07 |
| Last Update Date | 2012-01-20 |