| NPI | 1720678246 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | CHARLES E KITCHENS Business Owner 478-443-0964 |
| Organization Subpart ? | No |
| Primary Taxonomy | 261QM1300X Clinic/Center, Multi-Specialty |
| Additional Taxonomies | 363L00000X Nurse Practitioner |
| Enumeration Date | 2021-01-19 |
| Last Update Date | 2021-05-11 |