| NPI | 1982044707 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | ORTELIO BOSCH Owner 912-233-6811 |
| Organization Subpart ? | No |
| Primary Taxonomy | 261QA1903X Clinic/Center, Ambulatory Surgical (Licence: GA 051119) |
| Enumeration Date | 2013-06-25 |
| Last Update Date | 2013-06-25 |