| NPI | 1841573458 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | ALICE GROSS Administrator 770-389-0446 |
| Organization Subpart ? | No |
| Primary Taxonomy | 2086S0122X Surgery Plastic and Reconstructive Surgery |
| Enumeration Date | 2011-09-21 |
| Last Update Date | 2011-09-21 |