| NPI | 1205440054 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | LINDSEY NICOLE PARKS Owner/CEO 770-325-0836 |
| Organization Subpart ? | No |
| Primary Taxonomy | 363AS0400X Physician Assistant, Surgical |
| Additional Taxonomies | 208600000X Surgery |
| 246ZC0007X Specialist/Technologist, Other, Surgical Assistant | |
| Enumeration Date | 2020-08-31 |
| Last Update Date | 2020-08-31 |