| NPI | 1629113501 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | EVERETT JAMES MASON Owner 770-251-8940 |
| Organization Subpart ? | No |
| Primary Taxonomy | 261QA1903X Clinic/Center, Ambulatory Surgical (Licence: GA 038-343) |
| Enumeration Date | 2007-02-20 |
| Last Update Date | 2010-03-15 |