| NPI | 1902213432 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | MARCUS CRAWFORD President 770-794-6643 |
| Organization Subpart ? | No |
| Primary Taxonomy | 261QA1903X Clinic/Center, Ambulatory Surgical (Licence: GA LNRASC2014004) |
| Enumeration Date | 2014-07-16 |
| Last Update Date | 2014-07-16 |