| NPI | 1154502466 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | VIKKI FALLS Managing Director 309-846-4716 |
| Organization Subpart ? | No |
| Primary Taxonomy | 246ZC0007X Specialist/Technologist, Other, Surgical Assistant |
| Enumeration Date | 2007-11-15 |
| Last Update Date | 2018-10-19 |