| NPI | 1053649558 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | GREGORY E BERTUCCI Owner 228-385-2020 |
| Organization Subpart ? | No |
| Primary Taxonomy | 261QA1903X Clinic/Center, Ambulatory Surgical |
| Additional Taxonomies | 261QS0132X Clinic/Center, Ophthalmologic Surgery |
| Enumeration Date | 2009-11-23 |
| Last Update Date | 2025-07-29 |