| NPI | 1922054410 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | RITA Y WARREN Administrator 912-267-1802 |
| Organization Subpart ? | No |
| Primary Taxonomy | 261QA1903X Clinic/Center, Ambulatory Surgical (Licence: GA 063-134) |
| Enumeration Date | 2006-05-26 |
| Last Update Date | 2008-05-14 |