NPI | 1215040464 |
---|---|
Former Legal Business Name | DEERPATH ORTHOPEDIC SURGICAL CENTER |
Entity Type | Organization |
Authorized Contact | ASHLEY HILLIARD Administrator 815-318-5626 |
Organization Subpart ? | No |
Primary Taxonomy | 261QA1903X Clinic/Center, Ambulatory Surgical |
Enumeration Date | 2006-08-15 |
Last Update Date | 2022-09-02 |