| NPI | 1346736030 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | KELSEY CRATER CEO 770-687-9068 |
| Organization Subpart ? | No |
| Primary Taxonomy | 363AS0400X Physician Assistant, Surgical |
| Additional Taxonomies | 163WR0006X Registered Nurse, Registered Nurse First Assistant |
| Enumeration Date | 2018-07-05 |
| Last Update Date | 2018-07-05 |