| NPI | 1427420421 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | TY LELLOCK Practice Manager 412-623-6910 |
| Organization Subpart ? | Yes |
| Primary Taxonomy | 363AS0400X Physician Assistant, Surgical (Licence: PA ma057919) |
| Enumeration Date | 2015-10-29 |
| Last Update Date | 2015-10-29 |