NPI | 1467537951 |
---|---|
Entity Type | Organization |
Authorized Contact | JOHN MARK PETTIT Owner Doctor 360-671-9197 |
Organization Subpart ? | No |
Primary Taxonomy | 261QA1903X Clinic/Center, Ambulatory Surgical (Licence: WA 602558844) |
Enumeration Date | 2006-10-25 |
Last Update Date | 2007-11-19 |