| NPI | 1245305879 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | TATIANA SYCHEVA-JOHNSON Billing Manager 470-563-6468 |
| Organization Subpart ? | No |
| Primary Taxonomy | 207YX0905X Otolaryngology, Otolaryngology/Facial Plastic Surgery |
| Enumeration Date | 2006-11-21 |
| Last Update Date | 2024-12-16 |