| NPI | 1558583195 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | ROY TRUMAN KELLER Sole Provider 520-404-8562 |
| Organization Subpart ? | No |
| Primary Taxonomy | 246ZS0410X Specialist/Technologist, Other, Surgical Technologist |
| Enumeration Date | 2007-05-03 |
| Last Update Date | 2020-08-22 |