| NPI | 1700152113 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | ROBERT W. CUSHNER President/Owner 912-489-6519 |
| Organization Subpart ? | No |
| Primary Taxonomy | 261QA1903X Clinic/Center, Ambulatory Surgical |
| Enumeration Date | 2012-03-29 |
| Last Update Date | 2012-04-03 |