| NPI | 1215604624 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | LESLIE BAILEY President 815-671-2140 |
| Organization Subpart ? | No |
| Primary Taxonomy | 246ZC0007X Specialist/Technologist, Other, Surgical Assistant |
| Enumeration Date | 2021-08-24 |
| Last Update Date | 2021-08-24 |