| NPI | 1699759035 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | KLANCY LAUREN OWENS Practice Manager 706-278-2700 |
| Organization Subpart ? | No |
| Primary Taxonomy | 261QA1903X Clinic/Center Ambulatory Surgical (Licence: GA ASTC001175) |
| Enumeration Date | 2005-11-30 |
| Last Update Date | 2012-11-30 |