| NPI | 1205443876 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | DEBORAH REDMOND Surgical Assistant, Owner 757-343-4735 |
| Organization Subpart ? | No |
| Primary Taxonomy | 363AS0400X Physician Assistant, Surgical |
| Additional Taxonomies | 208600000X Surgery |
| 261QA1903X Clinic/Center, Ambulatory Surgical | |
| Enumeration Date | 2020-09-28 |
| Last Update Date | 2020-11-11 |