| NPI | 1023039385 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | SAMUEL W. RICHWINE Medical Director 770-534-1856 |
| Organization Subpart ? | No |
| Primary Taxonomy | 261QA1903X Clinic/Center, Ambulatory Surgical (Licence: GA 069-037) |
| Enumeration Date | 2006-07-22 |
| Last Update Date | 2020-08-22 |