| NPI | 1255097812 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | JUSTIN DWAYNE CRAWFORD Owner 940-642-9740 |
| Organization Subpart ? | No |
| Primary Taxonomy | 246ZC0007X Specialist/Technologist, Other, Surgical Assistant |
| Enumeration Date | 2021-11-09 |
| Last Update Date | 2021-11-09 |