| NPI | 1760985311 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | SHALI M. REYNOLDS President/CEO 912-656-6122 |
| Organization Subpart ? | No |
| Primary Taxonomy | 363LA2200X Nurse Practitioner, Adult Health (Licence: GA RN140169) |
| Enumeration Date | 2018-03-09 |
| Last Update Date | 2018-04-06 |