| NPI | 1487782637 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | NICOLE SINCLAIR Manager 229-247-4114 |
| Organization Subpart ? | No |
| Primary Taxonomy | 261QA1903X Clinic/Center, Ambulatory Surgical (Licence: GA 11-c0001153) |
| Enumeration Date | 2007-03-01 |
| Last Update Date | 2020-08-22 |