| NPI | 1710476098 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | KIMBERLY DAVIS Credentialing Specialtsts 912-484-3879 |
| Organization Subpart ? | No |
| Primary Taxonomy | 111N00000X Chiropractor (Licence: GA CHIR009974) |
| Enumeration Date | 2018-05-02 |
| Last Update Date | 2018-06-16 |