| NPI | 1629904586 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | DESTIN SUTTON Csfa 678-994-2312 |
| Organization Subpart ? | No |
| Primary Taxonomy | 246ZC0007X Specialist/Technologist, Other, Surgical Assistant |
| Enumeration Date | 2026-06-19 |
| Last Update Date | 2026-06-19 |