| NPI | 1780884817 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | CHANDRA LYNNETTE EDWARDS Business Manager 706-243-2900 |
| Organization Subpart ? | No |
| Primary Taxonomy | 207Q00000X Family Medicine (Licence: GA 049971) |
| Enumeration Date | 2007-07-18 |
| Last Update Date | 2011-02-15 |