| NPI | 1285158857 | 
|---|---|
| Entity Type | Organization | 
| Authorized Contact | PAM PHILLIP Patient Acc Mgr 770-985-4257 | 
| Organization Subpart ? | No | 
| Primary Taxonomy | 246ZC0007X Specialist/Technologist, Other, Surgical Assistant (Licence: GA 95152) | 
| Enumeration Date | 2017-07-26 | 
| Last Update Date | 2017-07-26 |