| NPI | 1942353115 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | ALICE GROSS Administrator 770-389-0446 |
| Organization Subpart ? | No |
| Primary Taxonomy | 261QA1903X Clinic/Center Ambulatory Surgical (Licence: GA 035432) |
| Enumeration Date | 2007-01-19 |
| Last Update Date | 2012-02-17 |