| NPI | 1285655464 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | SHELBY RAY WILKES Medical Director 404-881-6417 |
| Organization Subpart ? | Yes |
| Primary Taxonomy | 261QA1903X Clinic/Center, Ambulatory Surgical (Licence: GA 11-C0001213) |
| Enumeration Date | 2006-07-22 |
| Last Update Date | 2012-06-21 |