| NPI | 1346941804 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | DERRIC RENTON President 812-923-2050 |
| Organization Subpart ? | No |
| Primary Taxonomy | 246ZC0007X Specialist/Technologist, Other, Surgical Assistant |
| Enumeration Date | 2023-03-13 |
| Last Update Date | 2023-03-13 |