| NPI | 1396224044 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | PRISCILLA HOLLINGSWORTH Office Staff 866-996-2340 |
| Organization Subpart ? | Yes |
| Primary Taxonomy | 261QA1903X Clinic/Center, Ambulatory Surgical |
| Enumeration Date | 2018-08-13 |
| Last Update Date | 2024-06-09 |