| NPI | 1770596256 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | DAVID J FAULK Owner 912-265-7382 |
| Organization Subpart ? | No |
| Primary Taxonomy | 2084P0800X Psychiatry & Neurology, Psychiatry (Licence: GA 039787) |
| Enumeration Date | 2006-08-14 |
| Last Update Date | 2021-02-08 |