| NPI | 1437601549 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | DEBORAH A MARTIN Owner 770-844-2144 |
| Organization Subpart ? | No |
| Primary Taxonomy | 261QM2500X Clinic/Center Medical Specialty |
| Additional Taxonomies | 208600000X Surgery |
| Enumeration Date | 2016-10-25 |
| Last Update Date | 2020-05-12 |