| NPI | 1184882938 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | KRISTEN NAGRANI President 386-423-5500 |
| Organization Subpart ? | No |
| Primary Taxonomy | 261QA1903X Clinic/Center, Ambulatory Surgical (Licence: FL 1017) |
| Enumeration Date | 2008-05-29 |
| Last Update Date | 2008-05-29 |