| NPI | 1407200744 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | NIKI JOHNSON Credentialer 855-888-3749 |
| Organization Subpart ? | Yes |
| Primary Taxonomy | 261QE0800X Clinic/Center Endoscopy (Licence: NC 47590) |
| Enumeration Date | 2016-04-22 |
| Last Update Date | 2016-04-22 |