| NPI | 1871502799 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | KIMBERLY YOUNG PHILLIPS Owner, President 706-485-1145 |
| Organization Subpart ? | No |
| Primary Taxonomy | 207Q00000X Family Medicine (Licence: GA 051711) |
| Enumeration Date | 2006-08-07 |
| Last Update Date | 2008-05-14 |