| NPI | 1205256989 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | WEEMS R. PENNINGTON Healthcare Provider 706-840-5277 |
| Organization Subpart ? | No |
| Primary Taxonomy | 261QA1903X Clinic/Center, Ambulatory Surgical (Licence: SC 22253) |
| Enumeration Date | 2014-04-22 |
| Last Update Date | 2014-04-22 |