| NPI | 1972340453 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | SHARYSHMA DESHUN ANDERSON Owner/Operator 229-531-1035 |
| Organization Subpart ? | No |
| Primary Taxonomy | 261QH0100X Clinic/Center Health Service |
| Additional Taxonomies | 261QI0500X Clinic/Center Infusion Therapy |
| Enumeration Date | 2024-07-11 |
| Last Update Date | 2024-07-11 |