| NPI | 1093190837 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | TRACY C ECHUCK President 770-480-1311 |
| Organization Subpart ? | No |
| Primary Taxonomy | 246ZC0007X Specialist/Technologist, Other, Surgical Assistant (Licence: GA 153136) |
| Additional Taxonomies | 246ZS0410X Specialist/Technologist, Other, Surgical Technologist (Licence: GA 151286) |
| Enumeration Date | 2015-07-22 |
| Last Update Date | 2015-07-22 |