| NPI | 1164833398 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | CHRISTOPHER IBIKUNLE Administrator 678-466-6760 |
| Organization Subpart ? | No |
| Primary Taxonomy | 261QA1903X Clinic/Center, Ambulatory Surgical |
| Enumeration Date | 2014-05-09 |
| Last Update Date | 2014-05-20 |