NPI | 1760813034 |
---|---|
Entity Type | Organization |
Authorized Contact | EDWARD EARL PENNINGTON Physician/Manager 678-954-8538 |
Organization Subpart ? | No |
Primary Taxonomy | 208C00000X Colon & Rectal Surgery (Licence: GA 015299) |
Enumeration Date | 2013-12-11 |
Last Update Date | 2013-12-11 |