| NPI | 1174917033 |
|---|---|
| Doing Business As | JEFFERSON HEALTHCARE UROLOGY CLINIC |
| Doing Business As | JEFFERSON UROLOGY CLINIC |
| Entity Type | Organization |
| Authorized Contact | MIKE GLENN CEO 360-385-2200 |
| Organization Subpart ? | No |
| Primary Taxonomy | 208800000X Urology (Licence: WA hac.fs.00000085) |
| Enumeration Date | 2015-03-27 |
| Last Update Date | 2020-10-29 |