| NPI | 1427020007 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | RICHARD FARR Director 912-681-6132 |
| Organization Subpart ? | No |
| Primary Taxonomy | 261QA1903X Clinic/Center, Ambulatory Surgical (Licence: GA 016-285) |
| Enumeration Date | 2006-02-07 |
| Last Update Date | 2020-08-22 |