| NPI | 1740560978 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | DOUGLAS TOUSSAINT JOHNSON Owner 404-296-5005 |
| Organization Subpart ? | No |
| Primary Taxonomy | 363AS0400X Physician Assistant, Surgical (Licence: GA 6115) |
| Enumeration Date | 2011-08-19 |
| Last Update Date | 2011-08-19 |