| NPI | 1841371580 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | JENNIFER TARDIF Credentialing Manager 770-801-2526 |
| Organization Subpart ? | No |
| Primary Taxonomy | 207X00000X Orthopaedic Surgery (Licence: GA 012536) |
| Enumeration Date | 2006-10-18 |
| Last Update Date | 2020-08-22 |