| NPI | 1134412604 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | CHRIS JAY AUGUSTIAN Chief Executive Officer 920-405-5382 |
| Organization Subpart ? | No |
| Primary Taxonomy | 207X00000X Orthopaedic Surgery |
| Additional Taxonomies | 208800000X Urology |
| 332B00000X Durable Medical Equipment & Medical Supplies | |
| Enumeration Date | 2011-05-17 |
| Last Update Date | 2022-04-13 |