| 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 |