| NPI | 1376797332 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | CHARLES WILLIAM MITCHELL Manager 912-280-9977 |
| Organization Subpart ? | No |
| Primary Taxonomy | 261QA1903X Clinic/Center, Ambulatory Surgical (Licence: GA 063-383) |
| Enumeration Date | 2008-11-04 |
| Last Update Date | 2020-10-28 |