| Organization Name: | DENIS MORIN |
| NPI Number: | 1689770414 |
| Entity Type Code: | Organizational (2) |
| Authorized Official Name: | MELANIE D COGGINS (OFFICE MANAGER) |
| Mailing Address: | 30 Buchanan Byp Buchanan |
| State: | GA US |
| Postal Code: | 301134924 |
| Phone Number: | 7706468281 |
| Fax Number: | 7706463579 |
| NPI Enumeration Date: | 09/16/2006 |
| NPI Last Update Date: | 12/14/2010 |
| Replacement NPI: | 0 |
| NPI Deactivation Date: | |
| NPI Reactivation Date: |
Taxonomy Information: | |
| Healthcare Provider Taxonomy: | 261QR1300X |
| License Number: | 024466 |
| Healthcare Provider Taxonomy: (Secondary) | Y |
| State: | GA |
| Taxonomy Type: | Ambulatory Health Care Facilities |
| Taxonomy Classification: | Clinic/Center |
| Taxonomy Specialization: | Rural Health |
| Taxonomy Definition: | |