| NPI | 1932487691 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | KIMBERLY VERNELL DONALDSON Office Manager 706-396-0604 |
| Organization Subpart ? | No |
| Primary Taxonomy | 2080P0006X Pediatrics, Developmental - Behavioral Pediatrics (Licence: GA 044184) |
| Enumeration Date | 2011-07-29 |
| Last Update Date | 2015-02-13 |