| NPI | 1942748397 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | SHANNON KUYKENDALL Business Services Manager 706-542-8638 |
| Organization Subpart ? | No |
| Primary Taxonomy | 261QM1300X Clinic/Center, Multi-Specialty (Licence: GA LD004286) |
| Enumeration Date | 2017-02-06 |
| Last Update Date | 2017-02-06 |