| NPI | 1235405747 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | DONNA L FISHER Chief Administrative Officer 770-429-7741 |
| Organization Subpart ? | Yes |
| Primary Taxonomy | 207XX0005X Orthopaedic Surgery, Sports Medicine (Licence: GA 31591) |
| Additional Taxonomies | 207XX0005X Orthopaedic Surgery, Sports Medicine (Licence: GA 64509) |
| Enumeration Date | 2012-03-29 |
| Last Update Date | 2012-03-29 |