| NPI | 1881072379 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | LORI ATKINS Practice Manager 706-353-7648 |
| Organization Subpart ? | No |
| Primary Taxonomy | 261QP2300X Clinic/Center, Primary Care |
| Additional Taxonomies | 363AM0700X Physician Assistant, Medical |
| Enumeration Date | 2015-05-15 |
| Last Update Date | 2015-05-15 |