| NPI | 1780860924 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | GARY A LEVENGOOD Owner 770-237-3475 |
| Organization Subpart ? | No |
| Primary Taxonomy | 207XX0005X Orthopaedic Surgery, Sports Medicine (Licence: GA 040138) |
| Enumeration Date | 2008-01-17 |
| Last Update Date | 2008-01-17 |