| NPI | 1548470826 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | EUGENE DALE EDDLEMON Owner 530-345-9455 |
| Organization Subpart ? | No |
| Primary Taxonomy | 2086S0129X Surgery, Vascular Surgery (Licence: CA G68376) |
| Additional Taxonomies | 208600000X Surgery (Licence: CA G68376) |
| Enumeration Date | 2007-05-23 |
| Last Update Date | 2018-06-21 |