| NPI | 1912159062 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | GARY MYRTHIL President 478-953-2212 |
| Organization Subpart ? | No |
| Primary Taxonomy | 261QM2500X Clinic/Center, Medical Specialty (Licence: GA 038886) |
| Enumeration Date | 2008-10-21 |
| Last Update Date | 2022-07-21 |