| NPI | 1750629325 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | VERNON E SPELLMAN Administrator 678-872-8750 |
| Organization Subpart ? | No |
| Primary Taxonomy | 261QA1903X Clinic/Center, Ambulatory Surgical (Licence: GA 23819) |
| Enumeration Date | 2013-01-16 |
| Last Update Date | 2013-01-16 |