NPI | 1548221781 |
---|---|
Entity Type | Organization |
Authorized Contact | CARL E RUDD Administrator 731-422-0330 |
Organization Subpart ? | No |
Primary Taxonomy | 261QA1903X Clinic/Center Ambulatory Surgical (Licence: TN 0000000030) |
Enumeration Date | 2006-03-29 |
Last Update Date | 2020-08-22 |