NPI | 1962746701 |
---|---|
Entity Type | Organization |
Authorized Contact | JERI LYNN SHEFFIELD President 229-247-1163 |
Organization Subpart ? | No |
Primary Taxonomy | 261QP2300X Clinic/Center, Primary Care (Licence: GA 047945) |
Enumeration Date | 2012-11-17 |
Last Update Date | 2012-11-17 |