| NPI | 1407188659 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | SCOTT M STEWART Owner 678-928-4268 |
| Organization Subpart ? | No |
| Primary Taxonomy | 261QA1903X Clinic/Center, Ambulatory Surgical (Licence: GA 069-426) |
| Enumeration Date | 2010-02-12 |
| Last Update Date | 2014-11-05 |