| NPI | 1356305916 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | KEITH BALDWIN Administrator 706-292-3036 |
| Organization Subpart ? | No |
| Primary Taxonomy | 261QA1903X Clinic/Center Ambulatory Surgical (Licence: GA 057045) |
| Enumeration Date | 2006-04-12 |
| Last Update Date | 2014-05-06 |