| NPI | 1760643761 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | ANGELA HAYNES Office Manager 706-367-7302 |
| Organization Subpart ? | No |
| Primary Taxonomy | 363LF0000X Nurse Practitioner, Family (Licence: GA r100015) |
| Enumeration Date | 2008-06-23 |
| Last Update Date | 2008-06-23 |