| NPI | 1821106923 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | JUDY L GILLIAM Billing Manager 912-354-9447 |
| Organization Subpart ? | No |
| Primary Taxonomy | 261QA1903X Clinic/Center, Ambulatory Surgical (Licence: GA 86172S) |
| Enumeration Date | 2006-08-28 |
| Last Update Date | 2009-03-09 |