| NPI | 1609872597 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | KAY BUXTON Administrator 478-742-1403 |
| Organization Subpart ? | No |
| Primary Taxonomy | 261QA1903X Clinic/Center, Ambulatory Surgical (Licence: GA 011-188) |
| Enumeration Date | 2005-06-24 |
| Last Update Date | 2021-08-24 |