| NPI | 1790394120 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | DENNIS PRICE Practice Manager 770-559-8725 |
| Organization Subpart ? | No |
| Primary Taxonomy | 246ZC0007X Specialist/Technologist, Other, Surgical Assistant |
| Enumeration Date | 2020-07-31 |
| Last Update Date | 2020-07-31 |