| NPI | 1053466615 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | HEATHER A COUCH Cma, Adminisrtative 770-532-0503 |
| Organization Subpart ? | No |
| Primary Taxonomy | 207XX0005X Orthopaedic Surgery, Sports Medicine |
| Enumeration Date | 2007-01-24 |
| Last Update Date | 2020-08-22 |