| NPI | 1609544493 |
|---|---|
| Doing Business As | RESURGIA FAYETTEVILLE |
| Entity Type | Organization |
| Authorized Contact | KEVIN CHARLES General Manager 404-445-5304 |
| Organization Subpart ? | Yes |
| Primary Taxonomy | 261QM1300X Clinic/Center, Multi-Specialty |
| Enumeration Date | 2021-09-06 |
| Last Update Date | 2021-09-06 |