| NPI | 1801803820 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | JONATHAN MITCHELL COOK Owner/Manager 706-353-7747 |
| Organization Subpart ? | No |
| Primary Taxonomy | 207Q00000X Family Medicine (Licence: GA 042549) |
| Enumeration Date | 2006-08-02 |
| Last Update Date | 2023-11-13 |