| NPI | 1891190674 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | REBECCA TARLTON Physician 478-272-2255 |
| Organization Subpart ? | No |
| Primary Taxonomy | 261QX0203X Clinic/Center Oncology, Radiation |
| Additional Taxonomies | 174400000X Specialist (Licence: GA 028470) |
| Enumeration Date | 2014-10-23 |
| Last Update Date | 2023-09-07 |