| NPI | 1760668586 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | DANA M HARRELSON Office Manager 478-745-9559 |
| Organization Subpart ? | No |
| Primary Taxonomy | 261QP2300X Clinic/Center, Primary Care (Licence: GA 040767) |
| Enumeration Date | 2008-01-10 |
| Last Update Date | 2008-01-10 |