| NPI | 1720796980 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | PATRICIA P KELLER Owner 770-940-0185 |
| Organization Subpart ? | No |
| Primary Taxonomy | 246ZC0007X Specialist/Technologist, Other, Surgical Assistant |
| Enumeration Date | 2022-11-07 |
| Last Update Date | 2022-11-07 |