| NPI | 1619036928 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | LAVERNE W POINDEXTER Executive Administrator 770-270-5229 |
| Organization Subpart ? | No |
| Primary Taxonomy | 2086S0129X Surgery, Vascular Surgery (Licence: GA 029071) |
| Enumeration Date | 2006-12-06 |
| Last Update Date | 2020-08-22 |