| NPI | 1730326778 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | JOSE A. CANEDO Solo Practitioner/Owner 706-571-0121 |
| Organization Subpart ? | No |
| Primary Taxonomy | 261QH0100X Clinic/Center Health Service (Licence: GA 2084N0400X) |
| Enumeration Date | 2009-01-13 |
| Last Update Date | 2013-12-20 |