| NPI | 1235434275 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | STEPHEN HOLTCLAW Owner 770-688-3809 |
| Organization Subpart ? | No |
| Primary Taxonomy | 207L00000X Anesthesiology |
| Additional Taxonomies | 367500000X Nurse Anesthetist, Certified Registered |
| Enumeration Date | 2011-01-24 |
| Last Update Date | 2011-01-24 |