| NPI | 1568918548 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | NEIL GHODADRA Medical Director 678-596-1344 |
| Organization Subpart ? | No |
| Primary Taxonomy | 261QA1903X Clinic/Center Ambulatory Surgical (Licence: CA 116163) |
| Enumeration Date | 2016-08-30 |
| Last Update Date | 2016-08-30 |