| NPI | 1194746321 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | DIANNE S. THISTLETHWAITE Practice Administrator 404-257-1415 |
| Organization Subpart ? | No |
| Primary Taxonomy | 261QA1903X Clinic/Center, Ambulatory Surgical (Licence: GA 060-179) |
| Enumeration Date | 2006-07-22 |
| Last Update Date | 2015-07-30 |