| NPI | 1396078234 |
|---|---|
| Doing Business As | TRI-LAKES SURGERY CLINIC |
| Entity Type | Organization |
| Authorized Contact | MICHAEL HAVENS CEO 662-934-1140 |
| Organization Subpart ? | No |
| Primary Taxonomy | 208600000X Surgery (Licence: MS 13-287) |
| Enumeration Date | 2009-09-10 |
| Last Update Date | 2009-09-10 |