| NPI | 1851668834 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | HECTOR LUIS LUNA Captain/Physician's Assistant 706-787-1102 |
| Organization Subpart ? | No |
| Primary Taxonomy | 363AM0700X Physician Assistant, Medical (Licence: NC 0010-02514) |
| Enumeration Date | 2011-11-19 |
| Last Update Date | 2011-11-19 |