| NPI | 1851708242 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | JOHN JOYAVE Controller 706-625-5900 |
| Organization Subpart ? | No |
| Primary Taxonomy | 363LP0200X Nurse Practitioner, Pediatrics (Licence: GA RN211260) |
| Enumeration Date | 2014-07-17 |
| Last Update Date | 2020-05-12 |