| NPI | 1205149879 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | EMMANUEL S GRAHAM Director 340-719-8761 |
| Organization Subpart ? | No |
| Primary Taxonomy | 261Q00000X Clinic/Center (Licence: VI 1455) |
| Additional Taxonomies | 261QA1903X Clinic/Center, Ambulatory Surgical |
| Enumeration Date | 2010-07-23 |
| Last Update Date | 2023-12-08 |