| NPI | 1932577673 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | WESLEY LAGREGORY MITCHELL CEO 770-629-8289 |
| Organization Subpart ? | No |
| Primary Taxonomy | 363AS0400X Physician Assistant, Surgical (Licence: GA 3245) |
| Enumeration Date | 2015-09-11 |
| Last Update Date | 2016-09-02 |