| NPI | 1932280229 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | ANNE GAGNE Practice Administrator 706-568-2700 |
| Organization Subpart ? | No |
| Primary Taxonomy | 261QM2500X Clinic/Center, Medical Specialty (Licence: GA 6696501) |
| Enumeration Date | 2006-10-17 |
| Last Update Date | 2020-08-22 |