| NPI | 1427139732 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | DAVID L STREET President Of Corporation 541-930-8907 |
| Organization Subpart ? | No |
| Primary Taxonomy | 2086S0129X Surgery, Vascular Surgery |
| Additional Taxonomies | 208600000X Surgery |
| Enumeration Date | 2006-10-17 |
| Last Update Date | 2016-07-12 |