License Type Code = General
License Number = 1000901
Licensee Name = FIRST CHOICE PRIMARY CARE, INC.
Business Name = INGRAM PYE HEALTH CENTER
Business Address Line1 = 855 ANTHONY RD, STE 100
Business Address Line2 =
Business Address Line3 =
Business City = MACON
Business State = GA
Business Zip = 31204
Primary Phone = (478) 320-3529
Contact Name = KATHERINE K MCLEOD
License Status = Active
Start Of Business Date = 2015-09-18
Out Of Business Date =
Contractor = No
Application Date = 2015-09-18
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