| NPI | 1467128819 |
|---|---|
| Doing Business As | BLOOMINGTON ADVANCED SURGERY CENTER |
| Entity Type | Organization |
| Authorized Contact | WESLEY G LACKEY Medical Director 317-455-1064 |
| Organization Subpart ? | No |
| Primary Taxonomy | 261QA1903X Clinic/Center, Ambulatory Surgical |
| Enumeration Date | 2021-08-17 |
| Last Update Date | 2021-08-17 |