| NPI | 1003841511 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | GARY BENTON WILLIAMSON Owner 706-737-8827 |
| Organization Subpart ? | No |
| Primary Taxonomy | 261QA1903X Clinic/Center, Ambulatory Surgical (Licence: GA 121224) |
| Enumeration Date | 2006-07-12 |
| Last Update Date | 2020-08-22 |