| NPI | 1235433749 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | THOMAS MEDNOLIA VP 336-575-2833 |
| Organization Subpart ? | No |
| Primary Taxonomy | 261QA1903X Clinic/Center, Ambulatory Surgical (Licence: NJ 22512) |
| Enumeration Date | 2010-12-28 |
| Last Update Date | 2010-12-28 |