| NPI | 1013990308 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | CHARON P BARTLEY Billing Manager 706-724-5611 |
| Organization Subpart ? | No |
| Primary Taxonomy | 261QA1903X Clinic/Center, Ambulatory Surgical (Licence: GA 121-114) |
| Enumeration Date | 2005-11-21 |
| Last Update Date | 2020-07-22 |