| NPI | 1619004306 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | JEFFREY M GALLUPS CEO 770-740-1860 |
| Organization Subpart ? | No |
| Primary Taxonomy | 261QA1903X Clinic/Center Ambulatory Surgical (Licence: GA 060-137) |
| Enumeration Date | 2007-02-28 |
| Last Update Date | 2010-11-30 |