| NPI | 1396105904 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | MICHELLE LARUE CEO 770-330-5549 |
| Organization Subpart ? | No |
| Primary Taxonomy | 246ZC0007X Specialist/Technologist, Other, Surgical Assistant |
| Additional Taxonomies | 163WR0006X Registered Nurse, Registered Nurse First Assistant (Licence: GA RN195446) |
| 363AS0400X Physician Assistant, Surgical | |
| Enumeration Date | 2016-02-25 |
| Last Update Date | 2016-02-25 |