| NPI | 1982227781 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | RYAN S. TRETTIEN Executive Director 912-532-9308 |
| Organization Subpart ? | No |
| Primary Taxonomy | 261QR1300X Clinic/Center, Rural Health |
| Additional Taxonomies | 101YM0800X Counselor, Mental Health |
| 103TC0700X Psychologist, Clinical | |
| 1223E0200X Dentist, Endodontics | |
| 1223G0001X Dentist, General Practice | |
| 1223P0221X Dentist, Pediatric Dentistry | |
| 1223S0112X Dentist, Oral and Maxillofacial Surgery | |
| 183500000X Pharmacist | |
| 213E00000X Podiatrist | |
| 213ES0000X Podiatrist, Sports Medicine | |
| 213ES0103X Podiatrist, Foot & Ankle Surgery | |
| 225100000X Physical Therapist | |
| 225X00000X Occupational Therapist | |
| 261QM1300X Clinic/Center, Multi-Specialty | |
| 261QP2300X Clinic/Center, Primary Care | |
| Enumeration Date | 2020-05-27 |
| Last Update Date | 2020-09-16 |