| NPI | 1629346325 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | ELLIOTT P BUTLER Owner/President 706-614-7158 |
| Organization Subpart ? | No |
| Primary Taxonomy | 363AS0400X Physician Assistant, Surgical (Licence: GA PA000870) |
| Enumeration Date | 2011-12-08 |
| Last Update Date | 2011-12-08 |