| NPI | 1306732938 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | STEPHANIE BULLOCK Owner 470-243-0174 |
| Organization Subpart ? | No |
| Primary Taxonomy | 246ZC0007X Specialist/Technologist, Other, Surgical Assistant |
| Enumeration Date | 2025-06-18 |
| Last Update Date | 2025-07-02 |