| NPI | 1134517527 | 
|---|---|
| Entity Type | Organization | 
| Authorized Contact | PRISCILLA J ROSS Owner 912-656-3023 | 
| Organization Subpart ? | No | 
| Primary Taxonomy | 207LP2900X Anesthesiology, Pain Medicine (Licence: GA 058635) | 
| Enumeration Date | 2015-01-07 | 
| Last Update Date | 2023-08-30 |