| NPI | 1477047199 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | VIRGINIA MINICOZZI Practice Manager 770-391-3979 |
| Organization Subpart ? | No |
| Primary Taxonomy | 261QA1903X Clinic/Center, Ambulatory Surgical |
| Enumeration Date | 2018-06-16 |
| Last Update Date | 2019-06-11 |