| NPI | 1487950275 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | JOHN WALKER Owner 678-691-6529 |
| Organization Subpart ? | No |
| Primary Taxonomy | 363AS0400X Physician Assistant, Surgical (Licence: GA F01331) |
| Additional Taxonomies | 246ZS0410X Specialist/Technologist, Other, Surgical Technologist (Licence: GA F01331) |
| 246ZS0410X Specialist/Technologist, Other, Surgical Technologist (Licence: IL 238.000137) | |
| 246ZS0410X Specialist/Technologist, Other, Surgical Technologist | |
| Enumeration Date | 2011-01-27 |
| Last Update Date | 2016-03-24 |