| NPI | 1942735287 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | TIFFANY T BYRD Medical Director 706-442-1983 |
| Organization Subpart ? | No |
| Primary Taxonomy | 207Q00000X Family Medicine (Licence: GA 56623) |
| Enumeration Date | 2017-04-24 |
| Last Update Date | 2017-04-24 |