| NPI | 1992484190 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | MARCI R BROWN Owner, Authorized Official 706-219-2626 |
| Organization Subpart ? | No |
| Primary Taxonomy | 261Q00000X Clinic/Center |
| Additional Taxonomies | 207Q00000X Family Medicine |
| 3336C0002X Pharmacy Clinic Pharmacy | |
| Enumeration Date | 2023-07-14 |
| Last Update Date | 2025-08-15 |