| NPI | 1386673044 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | KENNETH A SON Medical Director 478-755-0354 |
| Organization Subpart ? | No |
| Primary Taxonomy | 261QA1903X Clinic/Center, Ambulatory Surgical (Licence: GA 043782) |
| Enumeration Date | 2006-07-02 |
| Last Update Date | 2020-08-22 |