| NPI | 1164979803 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | NEIL S. GHODADRA Physician/Director 678-596-1344 |
| Organization Subpart ? | No |
| Primary Taxonomy | 207XX0005X Orthopaedic Surgery, Sports Medicine |
| Enumeration Date | 2016-09-09 |
| Last Update Date | 2022-03-02 |