NPI | 1578531208 |
---|---|
Entity Type | Organization |
Authorized Contact | WILLIAM GORDON TANNER Director 678-879-0999 |
Organization Subpart ? | No |
Primary Taxonomy | 261QA1903X Clinic/Center, Ambulatory Surgical (Licence: GA 067329) |
Enumeration Date | 2006-03-09 |
Last Update Date | 2014-08-07 |