| NPI | 1881764553 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | MANAGED CARE Mgr, Provider Enrollment 404-785-5437 |
| Organization Subpart ? | No |
| Primary Taxonomy | 261QA1903X Clinic/Center, Ambulatory Surgical (Licence: GA 060-256) |
| Enumeration Date | 2006-11-09 |
| Last Update Date | 2024-04-17 |