| NPI | 1407065444 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | LUCILE G. LOTT Administrator 229-438-8685 |
| Organization Subpart ? | No |
| Primary Taxonomy | 261QA1903X Clinic/Center, Ambulatory Surgical (Licence: GA 047189) |
| Enumeration Date | 2007-05-22 |
| Last Update Date | 2020-08-22 |