| NPI | 1851660443 |
|---|---|
| Other Name | PALMYRA SURGICAL, LLC (MACON) |
| Entity Type | Organization |
| Authorized Contact | VITO JOHN BAGNATO Owner/President 229-432-8484 |
| Organization Subpart ? | No |
| Primary Taxonomy | 208600000X Surgery (Licence: GA 45711) |
| Enumeration Date | 2011-12-28 |
| Last Update Date | 2011-12-28 |