| NPI | 1801027008 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | ANTHONY VINCENT DITARANTO Owner/Physician 706-536-4690 |
| Organization Subpart ? | No |
| Primary Taxonomy | 261QP2300X Clinic/Center, Primary Care |
| Enumeration Date | 2009-08-05 |
| Last Update Date | 2018-10-19 |