| NPI | 1194272187 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | DANIEL J CONLEY President 239-260-3137 |
| Organization Subpart ? | No |
| Primary Taxonomy | 261QL0400X Clinic/Center, Lithotripsy (Licence: NV NV20151482876) |
| Enumeration Date | 2016-09-07 |
| Last Update Date | 2016-09-07 |