| NPI | 1871008086 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | LORI WECHSLER Billing Manager 912-844-7513 |
| Organization Subpart ? | No |
| Primary Taxonomy | 207XX0005X Orthopaedic Surgery, Sports Medicine (Licence: GA 75377) |
| Enumeration Date | 2017-12-11 |
| Last Update Date | 2017-12-11 |