| NPI | 1386672277 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | CHANHO H PARK Medical Director 706-546-0200 |
| Organization Subpart ? | No |
| Primary Taxonomy | 207ZP0101X Pathology, Anatomic Pathology (Licence: OH 35031213) |
| Additional Taxonomies | 291U00000X Clinical Medical Laboratory (Licence: OH 36D0656045) |
| Enumeration Date | 2006-06-29 |
| Last Update Date | 2011-07-22 |