| NPI | 1790974293 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | KENNEDY KELECHI OKERE Medical Director 912-826-3373 |
| Organization Subpart ? | No |
| Primary Taxonomy | 261Q00000X Clinic/Center (Licence: GA 50331) |
| Additional Taxonomies | 261QP2300X Clinic/Center, Primary Care (Licence: GA 50331) |
| Enumeration Date | 2007-10-20 |
| Last Update Date | 2009-10-25 |