| NPI | 1245623735 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | PAM PHILLIP Patient Account Manager 770-985-4257 |
| Organization Subpart ? | No |
| Primary Taxonomy | 246ZC0007X Specialist/Technologist, Other, Surgical Assistant (Licence: GA 1614) |
| Enumeration Date | 2015-03-09 |
| Last Update Date | 2015-03-09 |