| NPI | 1396188967 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | ANTHONY T CLAVO President 770-632-3730 |
| Organization Subpart ? | No |
| Primary Taxonomy | 261QA1903X Clinic/Center, Ambulatory Surgical (Licence: GA 0666736) |
| Enumeration Date | 2013-04-12 |
| Last Update Date | 2013-04-12 |