| NPI | 1922416171 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | CLISTA P TALLENT Practice Manager 706-279-1356 |
| Organization Subpart ? | No |
| Primary Taxonomy | 207R00000X Internal Medicine (Licence: GA 042315) |
| Enumeration Date | 2014-07-31 |
| Last Update Date | 2014-07-31 |