| NPI | 1295209286 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | ROBERT RAYBON Authorized Official 678-344-8900 |
| Organization Subpart ? | No |
| Primary Taxonomy | 261QA1903X Clinic/Center, Ambulatory Surgical |
| Enumeration Date | 2019-01-14 |
| Last Update Date | 2023-05-24 |