| NPI | 1821394602 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | RICHARD C BLOOM Medical Director 706-653-7008 |
| Organization Subpart ? | No |
| Primary Taxonomy | 261QA1903X Clinic/Center, Ambulatory Surgical (Licence: GA 106-459) |
| Enumeration Date | 2011-01-27 |
| Last Update Date | 2014-07-09 |