| NPI | 1538607544 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | WILLIAM MCELHAUGH Director 267-385-5538 |
| Organization Subpart ? | Yes |
| Primary Taxonomy | 261QA1903X Clinic/Center, Ambulatory Surgical |
| Additional Taxonomies | 261QA1903X Clinic/Center, Ambulatory Surgical |
| Enumeration Date | 2017-02-09 |
| Last Update Date | 2024-01-26 |