| NPI | 1376614826 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | WESLEY LEWIS DANIEL Medical Director 770-536-4702 |
| Organization Subpart ? | No |
| Primary Taxonomy | 261QA1903X Clinic/Center Ambulatory Surgical (Licence: GA 069-279) |
| Enumeration Date | 2006-11-13 |
| Last Update Date | 2008-07-31 |