| NPI | 1497259188 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | DUSTIN FISHER Owner/Operator 913-205-5735 |
| Organization Subpart ? | No |
| Primary Taxonomy | 246ZC0007X Specialist/Technologist, Other, Surgical Assistant |
| Enumeration Date | 2018-03-19 |
| Last Update Date | 2018-03-19 |