| NPI | 1306544291 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | MICHAEL CLERVEUS Medical Director 833-216-4500 |
| Organization Subpart ? | No |
| Primary Taxonomy | 261QA1903X Clinic/Center, Ambulatory Surgical |
| Enumeration Date | 2023-02-20 |
| Last Update Date | 2023-02-20 |