| NPI | 1922127851 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | SHANNON LOCKE Office Manager 706-864-6700 |
| Organization Subpart ? | No |
| Primary Taxonomy | 261QP2300X Clinic/Center, Primary Care (Licence: GA 033810) |
| Enumeration Date | 2007-03-29 |
| Last Update Date | 2020-08-22 |