| NPI | 1275597056 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | JEFFREY PRUSIA CFO 706-879-4795 |
| Organization Subpart ? | No |
| Primary Taxonomy | 261QA1903X Clinic/Center, Ambulatory Surgical (Licence: GA 057282) |
| Enumeration Date | 2006-04-17 |
| Last Update Date | 2025-09-23 |