| NPI | 1942359906 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | SUNG CHANG Owner 706-653-7000 |
| Organization Subpart ? | No |
| Primary Taxonomy | 207LP2900X Anesthesiology, Pain Medicine |
| Additional Taxonomies | 332900000X Non-Pharmacy Dispensing Site |
| Enumeration Date | 2007-01-09 |
| Last Update Date | 2022-07-21 |