GWINNETT SURGERY CENTER, LLC
Ambulatory Health at Professional Dr, Lawrenceville, GA

License number
Georgia 10041103
Category
Ambulatory Health
Type
Ambulatory Surgical
Owner
Name: WALLACE F MARTIN M.D.
Title: MANAGER/OWNER
Phone: (770) 962-9977
Address
Address
631 Professional Dr SUITE 300, Lawrenceville, GA 30046
National Provider ID: 1871895821
LicenseFiles verified this license of Nov 7, 2017 at the National Plan and Provider Enumeration System.

Organization information

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GWINNETT SURGERY CENTER, LLC

631 Professional Dr SUITE 390, Lawrenceville, GA 30046

Industry:
Medical Doctor's Office
Registration:
Jun 7, 2010
State ID:
10041103
Business type:
Domestic Limited Liability Company
Surgical Technicians:
Wallace Martin (Manager, Owner),Martin Ford (Branch Manager),Wan L. Yang (Nurse Practitioner),...
Agent:
Wallace F. Martin,631 Professional Dr SUITE 390, Lawrenceville, GA (Physical)

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