| NPI | 1194261834 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | DAVID GAVIN DILLARD Owner/Physician 678-689-1100 |
| Organization Subpart ? | No |
| Primary Taxonomy | 261QA1903X Clinic/Center, Ambulatory Surgical |
| Enumeration Date | 2017-01-18 |
| Last Update Date | 2017-01-18 |