| NPI | 1194884684 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | WILLIAM GARRETSON President Of Corporation 251-943-8033 |
| Organization Subpart ? | No |
| Primary Taxonomy | 208600000X Surgery (Licence: AL DO208) |
| Additional Taxonomies | 2086S0102X Surgery Surgical Critical Care (Licence: AL DO208) |
| 2086S0129X Surgery Vascular Surgery (Licence: AL DO208) | |
| Enumeration Date | 2006-12-08 |
| Last Update Date | 2020-08-22 |