| NPI | 1093245458 |
|---|---|
| Doing Business As | GREAT LAKES SURGICAL SUITES |
| Entity Type | Organization |
| Authorized Contact | CHRISTOPHER HARTSHORN Officer/Authorized Official 314-800-2017 |
| Organization Subpart ? | No |
| Primary Taxonomy | 261QA1903X Clinic/Center, Ambulatory Surgical |
| Enumeration Date | 2017-06-18 |
| Last Update Date | 2021-03-26 |