| NPI | 1326073826 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | BRYAN T. GRISCHOW Owner 380-898-5561 |
| Organization Subpart ? | No |
| Primary Taxonomy | 208600000X Surgery |
| Additional Taxonomies | 174400000X Specialist (Licence: OH 35042997) |
| Enumeration Date | 2006-07-12 |
| Last Update Date | 2022-11-11 |