| NPI | 1225064363 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | MARK A. GOLD Managing Member 912-262-6552 |
| Organization Subpart ? | No |
| Primary Taxonomy | 261QA1903X Clinic/Center, Ambulatory Surgical (Licence: GA Applied) |
| Enumeration Date | 2006-06-23 |
| Last Update Date | 2020-08-22 |