| NPI | 1811361108 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | TAMMY CARPENTER Office Manager 912-235-6790 |
| Organization Subpart ? | No |
| Primary Taxonomy | 2084N0400X Psychiatry & Neurology, Neurology (Licence: GA 69851) |
| Additional Taxonomies | 2085R0202X Radiology, Diagnostic Radiology (Licence: GA 56094) |
| Enumeration Date | 2015-11-24 |
| Last Update Date | 2015-11-24 |