| NPI | 1760778765 |
|---|---|
| Doing Business As | TOWN LAKE ENDOSCOPY CENTER |
| Entity Type | Organization |
| Authorized Contact | DEBORA S ROWELL Manager 678-741-2317 |
| Organization Subpart ? | No |
| Primary Taxonomy | 261QA1903X Clinic/Center, Ambulatory Surgical (Licence: GA 028-451) |
| Additional Taxonomies | 261QE0800X Clinic/Center, Endoscopy |
| Enumeration Date | 2011-06-28 |
| Last Update Date | 2015-03-11 |