NPI | 1215306295 |
---|---|
Entity Type | Organization |
Authorized Contact | STEPHANIE INGRAM Certified Surgical Assistant 770-354-6940 |
Organization Subpart ? | No |
Primary Taxonomy | 363AS0400X Physician Assistant, Surgical |
Enumeration Date | 2015-09-19 |
Last Update Date | 2022-05-10 |