| 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 |