| NPI | 1457425159 |
|---|---|
| Doing Business As | LAKESHORE SURGICAL CENTER |
| Entity Type | Organization |
| Authorized Contact | CECILIA ASHLEIGH BATES Office Manager 770-531-1181 |
| Organization Subpart ? | No |
| Primary Taxonomy | 261QA1903X Clinic/Center, Ambulatory Surgical (Licence: GA GA LIC 022231) |
| Additional Taxonomies | 261QA1903X Clinic/Center, Ambulatory Surgical (Licence: GA DEA AG5691452) |
| Enumeration Date | 2006-11-17 |
| Last Update Date | 2009-03-10 |