| NPI | 1962883082 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | CATHERINE FRYSH Owner 770-485-7628 |
| Organization Subpart ? | No |
| Primary Taxonomy | 363AS0400X Physician Assistant, Surgical (Licence: GA 003278) |
| Enumeration Date | 2015-06-15 |
| Last Update Date | 2015-10-27 |