NPI | 1487651956 |
---|---|
Doing Business As | TRI-STATE DIGESTIVE DISORDER CENTER |
Entity Type | Organization |
Authorized Contact | DANIEL G FAGEL President 859-341-3575 |
Organization Subpart ? | No |
Primary Taxonomy | 261QA1903X Clinic/Center, Ambulatory Surgical (Licence: KY 300096) |
Enumeration Date | 2005-06-30 |
Last Update Date | 2015-01-13 |