| 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 |