| NPI | 1134497910 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | MELVIN LEE CHRISTOPHER FUSSELL Owner/Board Certified Urologist 478-333-6961 |
| Organization Subpart ? | No |
| Primary Taxonomy | 261QA1903X Clinic/Center, Ambulatory Surgical (Licence: GA 052565) |
| Enumeration Date | 2011-12-07 |
| Last Update Date | 2011-12-07 |