| NPI | 1720844020 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | KATRINA DENISE SCANNELLI Physician Assistant 912-250-5266 |
| Organization Subpart ? | No |
| Primary Taxonomy | 363AM0700X Physician Assistant, Medical |
| Enumeration Date | 2024-02-23 |
| Last Update Date | 2024-03-13 |