| NPI | 1861332215 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | KEVIN PATRICK HALL Certified Surgical First Assistant 678-717-9539 |
| Organization Subpart ? | No |
| Primary Taxonomy | 246Z00000X Specialist/Technologist, Other |
| Enumeration Date | 2026-03-28 |
| Last Update Date | 2026-03-28 |