| NPI | 1356497747 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | ALISHA STONE Credentialing Specialist 478-551-4642 |
| Organization Subpart ? | No |
| Primary Taxonomy | 261QA1903X Clinic/Center, Ambulatory Surgical |
| Additional Taxonomies | 207W00000X Ophthalmology |
| Enumeration Date | 2007-01-26 |
| Last Update Date | 2025-12-11 |