| NPI | 1750868782 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | ZEPHANIAH DWAYNE BAKER President 706-587-3906 |
| Organization Subpart ? | No |
| Primary Taxonomy | 261QH0100X Clinic/Center, Health Services (Licence: GA ADC000209) |
| Enumeration Date | 2018-07-23 |
| Last Update Date | 2018-07-27 |