| NPI | 1740336577 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | THOMAS E RUNYAN Medical Director, Physician 912-466-9111 |
| Organization Subpart ? | No |
| Primary Taxonomy | 261QA1903X Clinic/Center, Ambulatory Surgical (Licence: GA 063-355) |
| Enumeration Date | 2007-01-26 |
| Last Update Date | 2011-02-14 |