| NPI | 1841329794 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | ROBIN WALL Practice Manager 706-625-1275 |
| Organization Subpart ? | No |
| Primary Taxonomy | 261QM2500X Clinic/Center Medical Specialty (Licence: GA BJ2848337) |
| Enumeration Date | 2007-03-05 |
| Last Update Date | 2012-01-10 |