| NPI | 1265855795 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | KERRY TEEL President 770-643-5501 |
| Organization Subpart ? | No |
| Primary Taxonomy | 208VP0014X Pain Medicine, Interventional Pain Medicine |
| Additional Taxonomies | 204E00000X Oral & Maxillofacial Surgery |
| 207L00000X Anesthesiology | |
| 207LP2900X Anesthesiology, Pain Medicine | |
| 208VP0000X | |
| 367500000X Nurse Anesthetist, Certified Registered | |
| 367H00000X Anesthesiologist Assistant | |
| Enumeration Date | 2014-02-04 |
| Last Update Date | 2014-02-05 |