| NPI | 1699769703 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | ZACK ZEKE MARTIN President CEO 770-995-7989 |
| Organization Subpart ? | No |
| Primary Taxonomy | 261QA1903X Clinic/Center, Ambulatory Surgical (Licence: GA 111072) |
| Enumeration Date | 2005-09-02 |
| Last Update Date | 2020-08-22 |