| NPI | 1174580518 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | REENA A YONKOSKY Owner/ Medical Mgr 678-965-5860 |
| Organization Subpart ? | No |
| Primary Taxonomy | 261QA1903X Clinic/Center Ambulatory Surgical |
| Enumeration Date | 2006-04-28 |
| Last Update Date | 2013-08-20 |