| NPI | 1487094058 |
|---|---|
| Doing Business As | FOUNTAINS SPECIALTY SURGICAL CENTER |
| Entity Type | Organization |
| Authorized Contact | LEONEL K VANCE Medical Director 769-300-0720 |
| Organization Subpart ? | No |
| Primary Taxonomy | 261QA1903X Clinic/Center, Ambulatory Surgical |
| Enumeration Date | 2013-06-27 |
| Last Update Date | 2021-10-25 |