| NPI | 1750796256 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | JOY M MAHAFFEY Practice Administrator 706-353-0606 |
| Organization Subpart ? | No |
| Primary Taxonomy | 363LF0000X Nurse Practitioner, Family (Licence: GA RN198704) |
| Enumeration Date | 2014-06-24 |
| Last Update Date | 2014-06-24 |