NPI | 1518009430 |
---|---|
Entity Type | Organization |
Authorized Contact | BRANDY MARCZUK Practice Manager 678-625-5132 |
Organization Subpart ? | No |
Primary Taxonomy | 261QA1903X Clinic/Center, Ambulatory Surgical (Licence: GA 4034) |
Enumeration Date | 2007-02-14 |
Last Update Date | 2021-05-05 |