| NPI | 1346907359 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | MARY ROLLER Associate Director/Enrollment 770-312-5226 |
| Organization Subpart ? | No |
| Primary Taxonomy | 207XX0005X Orthopaedic Surgery Sports Medicine |
| Enumeration Date | 2021-11-24 |
| Last Update Date | 2022-07-13 |