| NPI | 1821583477 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | KEVIN O'NEAL Owner/Member 706-614-6086 |
| Organization Subpart ? | No |
| Primary Taxonomy | 261QP2300X Clinic/Center, Primary Care (Licence: GA 42378) |
| Enumeration Date | 2018-06-26 |
| Last Update Date | 2018-06-26 |