| NPI | 1225675812 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | AMISH TILARA Medical Director 678-878-4555 |
| Organization Subpart ? | No |
| Primary Taxonomy | 261QA1903X Clinic/Center, Ambulatory Surgical |
| Additional Taxonomies | 2085R0204X Radiology, Vascular & Interventional Radiology |
| Enumeration Date | 2019-12-03 |
| Last Update Date | 2019-12-03 |