| NPI | 1417077090 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | LORI SUZANNE CHAMPAGNE Sr. Manager Of Asc Operations 448-227-4172 |
| Organization Subpart ? | No |
| Primary Taxonomy | 261QA1903X Clinic/Center, Ambulatory Surgical |
| Enumeration Date | 2007-03-29 |
| Last Update Date | 2024-02-14 |