NPI | 1437164175 |
---|---|
Entity Type | Organization |
Authorized Contact | AMY DEBRUIN Billing Department Manager 920-751-8666 |
Organization Subpart ? | No |
Primary Taxonomy | 207WX0107X Ophthalmology Retina Specialist |
Enumeration Date | 2006-07-30 |
Last Update Date | 2023-08-29 |