| NPI | 1295137420 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | HOWARD LEE SHACKELFORD Surgeon 740-695-2443 |
| Organization Subpart ? | No |
| Primary Taxonomy | 246ZC0007X Specialist/Technologist, Other, Surgical Assistant (Licence: OH 07-102) |
| Enumeration Date | 2014-09-18 |
| Last Update Date | 2014-09-18 |