| NPI | 1558640292 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | RONALD KELLY Surgical First Assist 719-574-7781 |
| Organization Subpart ? | No |
| Primary Taxonomy | 246ZC0007X Specialist/Technologist, Other, Surgical Assistant (Licence: CO 11-235) |
| Enumeration Date | 2011-08-12 |
| Last Update Date | 2012-01-10 |