| NPI | 1104072453 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | GEORGIA LEE Chief Operating Officer 478-745-4206 |
| Organization Subpart ? | No |
| Primary Taxonomy | 261QA1903X Clinic/Center, Ambulatory Surgical |
| Enumeration Date | 2008-08-18 |
| Last Update Date | 2012-01-03 |